Urocortin-2 in acute heart failure: role as a marker of volume overload and pulmonary hypertension

ABSTRACT Background Urocortin (Ucn)-2 has shown promising therapeutic effects on heart failure (HF). However, there are still significant knowledge gaps regarding the role and modulation of the endogenous Ucn-2 axis in the cardiovascular system and, specifically, in acute HF. Methods We evaluated Ucn-2 levels in admission serum samples of 80 acute HF patients and assessed their association with clinical, analytical and echocardiographic parameters. Results Median age was 76.5 years, and 37 patients (46%) were male. Median serum Ucn-2 was 2.3ng/mL. Ucn-2 levels were positively associated with peripheral edemas (p=0.022), hepatomegaly (p=0.007) and sodium retention score (ρ=0.37, p=0.001) and inversely correlated with inferior vena cava collapse at inspiration (ρ=-0.37, p=0.001). Additionally, patients with higher Ucn-2 levels had a higher prevalence of right atrial dilation (p=0.027), right ventricle dilation (p=0.008), and higher systolic pulmonary artery pressure (ρ=0.34, p=0.002). Regarding analytical parameters, Ucn-2 correlated positively with log BNP (r=0.22, p=0.055) and inversely with uric acid (r=0.24, p=0.029) and total (r=-0.30, p=0.007) and low-density lipoprotein cholesterol (r=-0.23, p=0.038). No associations were found between Ucn-2 and age, sex or left heart structure or function. Conclusions Circulating Ucn-2 was associated with clinical and echocardiographic markers of volume overload and pulmonary hypertension in acute HF patients.