Urocortin (UCN), a member of the corticotrophin-releasing factor family, is expressed in heart, brain and gut. UCN has potent cardiostimulatory, cardioprotective, vasodilator and diuretic/natriuretic effects, and cardiac UCN expression is increased in heart failure (HF). In the present study, we investigated plasma levels of UCN in 119 patients with HF and 212 age- and gender-matched controls to clarify its relationship with gender and disease severity. UCN was elevated in HF [normal males, 19.5 (3.9–68.8) pmol/l and HF males, 50.2 (6.9–108.2) pmol/l, P<0.0005; normal females, 14.2 (3.9–53.5) pmol/l and HF females, 21.8 (3.9–112.5) pmol/l, P<0.001; values are medians (range)]. The relative increase was greater in males than females (P<0.03). UCN fell with increasing age, especially in HF patients (rs=-0.56, P<0.0005) and with increasing New York Heart Association (NYHA) class (rs=-0.55, P<0.0005). The fall in UCN levels with increasing NYHA class was reinforced by a significant correlation between UCN and ejection fraction (rs=0.45, P<0.0005) in HF patients. Although receiver operating characteristic (ROC) curves for diagnosis of all HF cases yielded an area under the curve (AUC) of 0.76, ROC AUCs for patients with early HF (NYHA class I and II) were better (0.91). ROC AUCs for logistic models incorporating N-terminal probrain natriuretic peptide (N-BNP) and UCN were better than either peptide alone. In conclusion, plasma UCN is elevated in HF, especially in its early stages. Its decline with increasing HF severity may expedite disease progression due to diminished cardioprotective/anti-inflammatory effects. UCN measurement may also complement N-BNP in the diagnosis of early HF.
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April 2004
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Research Article|
April 01 2004
Plasma urocortin in human systolic heart failure
Leong L. NG;
1University of Leicester Department of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, U.K.
Correspondence: Professor Leong Ng (e-mail [email protected]).
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Ian W. LOKE;
Ian W. LOKE
1University of Leicester Department of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, U.K.
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Russell J. O'BRIEN;
Russell J. O'BRIEN
1University of Leicester Department of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, U.K.
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Iain B. SQUIRE;
Iain B. SQUIRE
1University of Leicester Department of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, U.K.
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Joan E. DAVIES
Joan E. DAVIES
1University of Leicester Department of Cardiovascular Sciences, Clinical Sciences Building, Leicester Royal Infirmary, Leicester LE2 7LX, U.K.
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Publisher: Portland Press Ltd
Received:
September 19 2003
Revision Received:
November 03 2003
Accepted:
December 03 2003
Accepted Manuscript online:
December 03 2003
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2004 The Biochemical Society
2004
Clin Sci (Lond) (2004) 106 (4): 383–388.
Article history
Received:
September 19 2003
Revision Received:
November 03 2003
Accepted:
December 03 2003
Accepted Manuscript online:
December 03 2003
Citation
Leong L. NG, Ian W. LOKE, Russell J. O'BRIEN, Iain B. SQUIRE, Joan E. DAVIES; Plasma urocortin in human systolic heart failure. Clin Sci (Lond) 1 April 2004; 106 (4): 383–388. doi: https://doi.org/10.1042/CS20030311
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