Purpose: Left ventricular ejection fraction (LVEF) is the central parameter in the assessment of systolic heart failure (HFrEF). Novel biomarkers, such as copeptin, might lead to early diagnosis of left ventricular systolic dysfunction and thus lead to better clinical outcomes. This study aims to evaluate the association between copeptin and LVEF assessed by echocardiography.

Methods: Patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Patients with right ventricular dysfunction (TAPSE < 17 mm) were excluded. Blood samples for measurements of copeptin and NT-proBNP were collected at the day of echocardiographic examination. Subgroups based on LVEF grades were defined (0: left ventricular ejection fraction (LVEF) > 60 % (n=37); I: LVEF > 55 - ≤ 60% (n=40), II: LVEF > 45 - ≤ 55 % (n=32), III: LVEF > 35- ≤ 45 % (n=22), IV: LVEF ≤ 35 % (n=15).

Results: A total of 146 patients were included. Levels of copeptin as well as NT-proBNP increased significantly according to decreasing LVEF (copeptin: p=0.008, NT-proBNP: p=0.001). Furthermore, copeptin correlated significantly with LVEF (p=0.001). In multivariable linear regression models adjusted for clinical characteristics and cardiac comorbidities (age, sex, creatinine, NT-proBNP, arterial hypertension, coronary artery disease and LVEF), only LVEF, NT-proBNP and creatinine sustained significantly associated with copeptin (LVEF: Beta 0.158, T 2.299, p=0.023; NT-proBNP: Beta 0.235, T 3.353, p=0.001; creatinine: Beta 0.466, T 6.908, p=0.0001). Both, copeptin and NT-proBNP were able to discriminate patients with LVEF grade IV (copeptin: AUC=0.737, p=0.003; NT-proBNP: AUC=0.84, p=0.001).

Conclusions: This study demonstrates that copeptin is able to adequately reflect LVEF assessed by echocardiography and might thus be a useful marker for the detection of systolice heart failure.