{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T15:18:58Z","timestamp":1776352738785,"version":"3.51.2"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,9,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Coronary microvascular dysfunction (CMD) predicts mortality after ST\u2010elevation\u2013myocardial infarction (STEMI). Arginine vasopressin (AVP) may be implicated, but data in humans are lacking, and no study has investigated the link between arginine vasopressin and invasive measures of CMD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We invasively assessed CMD in 55 patients with STEMI treated with primary percutaneous coronary intervention (PPCI), by measuring the index of microcirculatory resistance after PPCI. In a separate group of 45 patients with STEMI\/PPCI, recruited for a clinical trial, we measured infarct size and microvascular obstruction with cardiac magnetic resonance (CMR) imaging at 1\u2009week and 12\u2009weeks post\u2010STEMI. Serum copeptin was measured at 4 time points before and after PPCI in all patients with STEMI. Plasma copeptin levels fell from 92.5\u2009pmol\/L before reperfusion to 6.4\u2009pmol\/L at 24\u2009hours. Copeptin inversely correlated with diastolic, but not systolic, blood pressure (r=\u22120.431,\n              <jats:italic>P<\/jats:italic>\n              =0.001), suggesting it is released in response to myocardial ischemia. Persistently raised copeptin at 24\u2009hours was correlated with higher index of microcirculatory resistance (r=0.372,\n              <jats:italic>P<\/jats:italic>\n              =0.011). Patients with microvascular obstruction on early CMR imaging showed a trend toward higher admission copeptin, which was not statistically significant. Copeptin levels were not associated with infarct size on either early or late CMR.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with CMD after STEMI have persistently elevated copeptin at 24\u2009hours, suggesting arginine vasopressin may contribute to microvascular dysfunction. Arginine vasopressin receptor antagonists may represent a novel therapeutic option in patients with STEMI and CMD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.030473","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T11:10:57Z","timestamp":1694171457000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Arginine Vasopressin Plays a Role in\u00a0Microvascular Dysfunction After ST\u2010Elevation Myocardial Infarction"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2335-9596","authenticated-orcid":false,"given":"Ayman","family":"Al\u2010Atta","sequence":"first","affiliation":[{"name":"Freeman Hospital Newcastle upon Tyne United Kingdom"},{"name":"Translational and Clinical Research Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences Newcastle University Newcastle Upon Tyne United 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