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Clinical and echocardiographic correlates of serum copper and zinc in acute and chronic heart failure

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Abstract

Aim

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.

Conclusion

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.

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Acknowledgments

The authors wish to thank Athanasia Kokkinari for her excellent technical assistance.

Conflict of interest

Gerasimos Gavrielatos: Currently, after the completion of the study, Dr. Gavrielatos works as a Medical Advisor in Boehringer Ingelheim and reports no conflict of interest related to the study. All other authors report no conflict of interest related to the study.

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Authors and Affiliations

  1. Department of Cardiology, Athens University Hospital Attikon, Athens, Greece

    Ioannis Alexanian, John Parissis, Dimitrios Farmakis, Constantinos Mihas, Ioannis Paraskevaidis, Dimitrios Kremastinos, Maria Anastasiou-Nana, John Lekakis & Gerasimos Filippatos

  2. Second Department of Cardiology, Evangelismos General Hospital, Athens, Greece

    Loukas Pappas, Gerasimos Gavrielatos & Antonios Sideris

  3. Department of Forensic Medicine and Toxicology, Medical School, University of Athens, Athens, Greece

    Sotirios Athanaselis & Chaido Spiliopoulou

  4. Rimini 1, Chaidari, 12461, Athens, Greece

    John Parissis

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  1. Ioannis Alexanian
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Correspondence to John Parissis.

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Alexanian, I., Parissis, J., Farmakis, D. et al. Clinical and echocardiographic correlates of serum copper and zinc in acute and chronic heart failure. Clin Res Cardiol 103, 938–949 (2014). https://doi.org/10.1007/s00392-014-0735-x

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  • DOI: https://doi.org/10.1007/s00392-014-0735-x

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