Abstract P536: The Association of Adipokines With Cardiac Structure and Function Among Older Adults Without Clinical Cardiovascular Disease

Abstract

Background: Heart failure (HF) is a growing public health concern. While dysfunctional adipose tissue is a key driver of HF risk in the population, the role of altered adipokine production by adipose tissue in the development of cardiac dysfunction is unknown. Methods: We conducted a cross-sectional analysis of ARIC Visit 5 (2011-13) participants free of coronary heart disease and HF. Using linear regression, we assessed the adjusted associations between the adipokines adiponectin, leptin, apelin, and resistin (per 1-SD) and echocardiographic parameters indicative of cardiac structure and function. Results: We included 3244 participants (mean age 75±5 years, 61% female, 16% Black, 31% with obesity). After adjusting for sociodemographic/lifestyle factors and eGFR, 1-SD higher adiponectin was associated with lower (worse) LV ejection fraction (LVEF), but a more negative (better) longitudinal strain (LS). Higher adiponectin was also associated with higher lateral and medial e’ and lower E/e’, reflecting better diastolic function. Conversely, higher leptin was associated with worse systolic and diastolic function, indicated by a less negative LS, lower lateral and medial e’, and higher E/e’. Higher leptin/adiponectin ratio was associated with better LVEF (β: 1.73, 95% CI: 0.04, 3.41), but worse LS (β: 1.87, 95% CI: 1.17, 2.57), as well as uniformly worse diastolic function (lateral e’ [β: -2.39, 95% CI: -2.99, -1.79], medial e’ [β: -1.43, 95% CI: -1.86, -0.99], E/e’ [β: 2.61, 95% CI: 1.56, 3.67]). Adjustment for clinical variables and BMI attenuated some associations, but resulted in associations of adiponectin with greater LV mass index, and leptin with lower LV mass index. Apelin and resistin had weak associations with cardiac function. Conclusion: Adiponectin and leptin are differentially associated with systolic and diastolic function. Further investigation of the adipokines’ opposing roles in the development of cardiac dysfunction may help elucidate the effect of dysfunctional adipose tissue on myocardium.