These findings indicate that total adiponectin is more useful for assessing mortality risk than HMW adiponectin and a high plasma total adiponectin is an independent prognostic predictor especially in CHF patients with normal BMI.

These findings suggest that decreased clearance from the kidney contributes to the elevated BNP in CHF patients with renal dysfunction, especially in patients with an eGFR <60 ml/min.

Methods PatientsStudy 1 Fifty consecutive patients with mild to severe CHF (left ventricular ejection fraction (LVEF) <45%, New York Heart Association (NYHA) functional classes II-IV) underwent diagnostic cardiac catheterization. Patients taking allopurinol, with renal failure, malignancy or congenital malformations of the heart or vessels were excluded. Renal failure was defined as an estimated glomerular filtration rate (eGFR) <30 ml · min -1 · (1.73 m 2 ) -1 according to the MDRD equation. 20 Informed consent was given by all patients before participating in the study, and the protocol Background A recent study suggested that xanthine oxidase is activated in congestive heart failure (CHF). However, whether uric acid (UA) is secreted from the failing heart remains unknown, so it is currently unclear whether serum UA can provide prognostic information independent of brain natriuretic peptide (BNP). Methods and ResultsSerum UA was measured in the aortic root (AO) and the coronary sinus (CS) of 74 patients with CHF. The serum UA level was significantly higher in the CS than in the AO. The transcardiac gradient of UA (CS -AO) increased with the severity of CHF, inversely correlated with left ventricular ejection fraction (LVEF) and positively correlated with left ventricular end-diastolic volume index. The plasma levels of norepinephrine, BNP, UA, and LVEF were monitored prospectively in 150 CHF patients for a mean follow-up of 3 years. High plasma levels of UA (p<0.001) and BNP (p<0.001) were shown by multivariate stepwise analysis to be independent predictors of mortality. Conclusions High plasma UA level, partly secreted from the failing heart, is a prognostic predictor independent of BNP in patients with CHF. Monitoring a combination of BNP and UA may be useful for the management of patients with CHF. (Circ J 2006; 70: 1006 -1011

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