The relationship between serum adiponectin and prognosis in patients with heart failure

Abstract

The role of adiponectin in the development of cardiac disease remains less clear than in metabolic disorders. While some studies indicated that low adiponectin levels were associated with cardiovascular disease, not all studies have been able to show such association. Adiponectin levels may influence the development of chronic heart failure, but the epidemiological data are somewhat complex. Thus, the aim of this study was a survey of relationship between serum Adiponectin and prognosis of patients with heart failure in Iran. In this cohort study, we evaluated 96 chronic heart failure patients. Patients with systolic dysfunction that was defined as left ventricular Ejection Fraction (EF) ≤40 % or had a history of heart failure were included in the study. At the baseline visit, all patients were examined by a physician and the following information was obtained: medical history, physical examination, New York Heart Association (NYHA) classification. After the first evaluation, analyses of adiponectin, Pro BNP, creatinine and uric acid were performed. Then the patients were followed up for a median of 12 months. There was a significant relationship between the mean adiponectin and Pro BNP levels and the ejection fraction (p=0.003 and p=0.003 respectively). Higher levels of adiponectin and Pro BNP were associated with a lower ejection fraction and there were no such associations between creatinine and uric acid levels. There was a significant association between the functional capacity as assessed by NYHA class and the mean of adiponectin and uric acid, these means that higher levels of adiponectin and uric acid were associated with a higher functional class in patients with CHF (p=0.03 and p=0.04 respectively). During a 12 month follow-up, 22 (22.9 %) patients died. In subjects who died, the baseline mean plasma adiponectin and Pro BNP levels were higher compared to those who were alive at the follow-up and these difference were statistically significant (19±7.4 vs.15.8±8 ng/ml and 9520±10249 vs. 3172±4628 ng/L p=0.000). The present study demonstrated that the plasma adiponectin level increased according to the severity of heart failure and also there was such relationship between Pro BNP and heart failure (Tab. 3, Ref. 35).