title: Clinical and echocardiographic correlates of serum copper and zinc in acute and chronic heart failure.
abstract: OBJECTIVE
  Emerging evidence suggests a pathophysiological role of micronutrient dyshomeostasis in heart failure, including promotion of adverse remodeling and clinical deterioration. We sought to evaluate serum copper (Cu) and zinc (Zn) levels in acute (AHF) and chronic (CHF) heart failure.
  
  
  METHODS
  We studied 125 patients, 71 % male, aged 69 ± 11 years, 37 % with preserved left ventricular ejection fraction (LVEF ≥40 %) (HFPEF), including 81 with AHF and 44 with CHF; 21 healthy volunteers served as controls. Serum Cu and Zn levels were determined using air-acetylene flame atomic absorption spectrophotometry.
  
  
  RESULTS
  Serum Cu levels were significantly higher in AHF (p = 0.006) and CHF (p = 0.002) patients compared to controls after adjusting for age, gender and comorbidities, whereas they did not differ between AHF and CHF (p = 0.840). Additionally, serum Cu in patients with LVEF <40 % was significantly higher compared to both controls (p < 0.001) and HFPEF patients (p = 0.003). Serum Zn was significantly lower in AHF (p < 0.001) and CHF (p = 0.039) compared to control after adjusting for the above-mentioned variables. Moreover, serum Zn was significantly lower in AHF than in CHF (p = 0.015). In multiple linear regression, LVEF (p = 0.033) and E/e ratio (p = 0.006) were independent predictors of serum Cu in total heart failure population, while NYHA class (p < 0.001) and E/e ratio (p = 0.007) were independent predictors of serum Zn.
  
  
  CONCLUSIONS
  Serum Cu was increased both in AHF and CHF and correlated with LV systolic and diastolic function. Serum Zn, in contrast, was decreased both in AHF and CHF and independently predicted by clinical status and LV diastolic function.
authors.affiliation: Department of Cardiology, Athens University Hospital Attikon, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Alexanian
authors.forename: John
authors.initials: J
authors.lastname: Parissis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Farmakis
authors.forename: Sotirios
authors.initials: S
authors.lastname: Athanaselis
authors.forename: Loukas
authors.initials: L
authors.lastname: Pappas
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Gavrielatos
authors.forename: Constantinos
authors.initials: C
authors.lastname: Mihas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Paraskevaidis
authors.forename: Antonios
authors.initials: A
authors.lastname: Sideris
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kremastinos
authors.forename: Chaido
authors.initials: C
authors.lastname: Spiliopoulou
authors.forename: Maria
authors.initials: M
authors.lastname: Anastasiou-Nana
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002908:Chronic Disease; D003300:Copper / Q000097:blood*; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006115:Greece; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D015032:Zinc / Q000097:blood*
chemical_list: D015415:Biomarkers; D003300:Copper; D015032:Zinc