Assessment of endothelin and copeptin as biomarkers for vasovagal syncope

Eur J Clin Invest. 2016 Feb;46(2):141-5. doi: 10.1111/eci.12576. Epub 2016 Jan 18.

Abstract

Background: The diagnosis of vasovagal syncope continues to be difficult despite the use of accurate histories, tilt testing and implantable loop recorders. A circulating biomarker might be useful to facilitate diagnoses. Both endothelin-1 and vasopressin are increased during positive tilt tests resulting in syncope. Copeptin is a stable cleavage product of vasopressin formation. We conducted a pilot study to assess the utility of endothelin-1 and copeptin as circulating biomarkers of vasovagal syncope.

Methods: Three populations were studied: syncope patients, epilepsy patients and controls. Vasovagal syncope diagnosis was ascertained with the Calgary Syncope Score and epilepsy diagnosis was confirmed with EEG. Plasma levels of endothelin-1 were measured using by ELISA and copeptin levels were determined using an EIA kit.

Results: Asymptomatic control subjects had mean age 35 ± 11 years (7/22 male); epileptic subjects had mean age 32 ± 7 years (4/15 male); and syncope subjects had mean age 33 ± 16 years (4 of 21 male). Circulating plasma levels of endothelin-1 and copeptin were no different among the three groups. Mean concentrations of endothelin-1 were as follows: syncope, 23 ± 32 pg/mL; controls, 21 ± 17 pg/mL; and epileptics, 18 ± 12 pg/mL. Mean concentrations of copeptin were as follows: syncope, 1·29 ± 0·79 ng/mL; controls, 1·25 ± 0·79 ng/mL; and seizures, 1·23 ± 0·45 ng/mL. There were no significant correlations between syncope frequency and copeptin or endothelin-1 levels.

Conclusion: Circulating plasma endothelin-1 and copeptin levels are not significantly different among populations of controls, syncope patients and seizure patients.

Keywords: Biomarkers; copeptin; diagnosis; endothelin; vasovagal syncope.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Case-Control Studies
  • Endothelin-1 / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Epilepsy / blood
  • Female
  • Glycopeptides / blood*
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Syncope, Vasovagal / blood*
  • Young Adult

Substances

  • Biomarkers
  • Endothelin-1
  • Glycopeptides
  • copeptins