title: The evaluation of the clinical utility of urocortin 1 and adrenomedullin versus proBNP in systolic heart failure.
abstract: OBJECTIVE
  Urocortin 1 (UCN1) has vasodilator, diuretic, and natriuretic effects, and its expression increases in heart failure (HF). Adrenomedullin (ADM) increases cardiac output and lowers blood pressure in healthy men and in patients with heart failure. The aim of the study was to determine UCN1 and ADM levels in patients with HF, to evaluate the relationship of UCN1 and ADM with various clinical parameters, and to assess UCN1 and ADM as diagnostic markers in HF, in comparison with pro-brain natriuretic peptide (pro-BNP).
  
  
  METHODS
  We investigated serum levels of UCN1, ADM, and pro BNP in 86 consecutive patients with systolic HF [ejection fraction (EF) ≤45%] and 85 healthy controls. Serum UCN1, ADM, and pro-BNP levels were measured with the ELISA method. Transthoracic echocardiography was performed to determine left ventricular EF and pulmonary artery systolic pressure.
  
  
  RESULTS
  UCN1 and ADM levels were higher in HF patients (446.2±145.7 pg/mL, p<0.001; 87.9±4.2 pg/mL, p<0.001 respectively). UCN1 was positively correlated with pro-BNP (r=0.963, p<0.001), ADM (r=0.915, p<0.001), and NYHA (r=0.879, p<0.001); ADM was positively correlated with pro-BNP (r=0.956, p<0.001) and NYHA (r=0.944, p<0.001). Receiver operating characteristic curves yielded an area under the curve of 1.00 (p<0.001) for UCN1, 1.00 (p<0.001) for ADM, and 0.99 (p<0.001) for pro-BNP in the diagnosis of HF.
  
  
  CONCLUSIONS
  UCN1 and ADM increase with worsening HF and left ventricular dysfunction. They may be used as diagnostic biomarkers in systolic HF, but the incremental value of measuring UCN1 and ADM in patients tested for pro-BNP is questionable.
authors: Erkan
authors: E
authors: Yıldırım
authors: Clinic of Cardiology, Erzurum Research and Training Hospital; Erzurum-Turkey. drmahirc@yahoo.com.
authors: Mahir
authors: M
authors: Cengiz
authors: Nilgün
authors: N
authors: Yıldırım
authors: Kürşat
authors: K
authors: Aslan
authors: Emrah
authors: E
authors: İpek
authors: Ali Fuat
authors: AF
authors: Korkmaz
authors: Fatih Rıfat
authors: FR
authors: Ulusoy
authors: Engin
authors: E
authors: Hatem
mesh_terms: D053607:Adrenomedullin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D054143:Heart Failure, Systolic / Q000097:blood* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012680:Sensitivity and Specificity; D054832:Urocortins / Q000097:blood
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D054832:Urocortins; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin