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Q&A

Hypertension

Poster Session 1

(311) Biomarkers of Poor Volume Handling Predict Preeclampsia in a Symptomatic Population

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

Copeptin, a marker of vasopressin secretion and fluid volume handling, is robustly predictive of the development of preeclampsia (PreE) in all three trimesters. Other markers of poor volume handling such as Brain Natriuretic Peptide (BNP) and Atrial Natriuretic Peptide (ANP) may also predict PreE. This translational, prospective cohort study aimed to evaluate these markers in a symptomatic population. We hypothesize that BNP, ANP, and Copeptin will be associated with those diagnosed with PreE. 

Study Design: In this Rule Out PreEclampsia (ROPE) Study (IRB# 201611746), birthing parents who presented for evaluation of PreE in the 3rd trimester due to signs or symptoms at a university medical center provided access to clinical information and plasma samples. Copeptin and ANP were measured using Time Resolved Amplified Cryptate Emission (TRACE) using a Kryptor Clinical Analyzer (ThermoFisher) and BNP was measured by commercial Enzyme-linked immunosorbent assays (ELISA). T tests, chi square, and logistic regression analyses were performed with a=0.05.

Results:

A total of 55 control and 104 PreE participants were recruited. Maternal age, race, body mass index, gravida, para, rate of chronic hypertension and diabetes were similar between the 2 groups.  Copeptin (14.3 ± 2.9 vs. 7.3 ± 0.7, p=0.02), BNP (362.2 ± 52.1 vs. 182.0 ± 52.1, p=0.03), and ANP (93.8 ± 6.4 vs. 62.4 ± 8.8, p=0.005) values were all significantly higher in those diagnosed with PreE.  After controlling for chronic hypertension and diabetes diagnoses, Copeptin (p=0.05), BNP (p=0.04), and ANP (p=0.009) remained significantly associated with the development of PreE. In addition, BNP values (r2=0.7, p=0.04) was significantly, positively correlated with Copeptin levels.

Conclusion:

These data suggest that Copeptin, BNP, and ANP may be adjunct diagnostic tools for PreE in a symptomatic population. In addition, the poor fluid handling these analytes indicate in the 3rd trimester provides further evidence that fluid imbalance may provide a molecular mechanism for the later stages of the disease.