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

Abstract

Abstract:Background: 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 infl uence 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. Methods and materials:In this cohort study, we evaluated 96 chronic heart failure patients. Patients with systolic dysfunction that was defi ned 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) classifi cation. After the fi rst evaluation, analyses of adiponectin, Pro BNP, creatinine and uric acid were performed. Then the patients were followed up for a median of 12 months. Results: There was a signifi cant 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 signifi cant 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 signifi cant (19±7.4 vs.15.8±8 ng/ml and 9520±10249 vs. 3172±4628 ng/L p=0.000). Conclusion: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). Full Text in PDF www.elis.sk.

The Predictivity of N-Terminal Pro b-Type Natriuretic Peptide for All-Cause Mortality in Various Follow-Up Periods among Heart Failure Patients

“…The 1-year mortality rate significantly elevated to 2.6-fold when the plasma NP-pro BNP above 2060 ng/L [28], or increased to 7.0-fold with the plasma NP-pro BNP above 10,000 ng/L [16]. Another outpatient-based investigation by Sokhanvar et al [14], which enrolled patients with systolic HF, also disclosed that the level of plasma NT-proBNP was positively correlated with mortality and morbidity at a follow-up period of six months. Besides, the study by Gardner et al [15] found that, for advanced chronic HF patients, a single level of plasma NT-proBNP >1505 ng/L (the median level of the participants) independently predicted of all-cause mortality within 554 days.…”

“…Because of the longer plasma half-life and lower intra-individual biological variation, NT-proBNP is considered a more reliable biomarker than BNP in clinical practice. Clinically, the plasma NT-proBNP level grossly reflects cardiac structure and function in HF patients [10,11,12], has good diagnostic performance for discriminating acute HF from a noncardiac entity in patients with new-onset dyspnea, and has good prognostic–predictive power in HF patients [13,14,15,16,17]. Noveanu et al [17] conducted a study to compare the prognostic–predictive power of individual NT-proBNP level obtained at different time points.…”

“…It is also reasonable to doubt that a single measurement of a biomarker for which levels vary along with the treatment course could predict long-term patient outcomes. Previously, several investigations demonstrated the prognostic–predictive power of the levels of NT-proBNP by using various study designs including the type of HF, patient ages, and follow-up periods of endpoints [13,14,15,16,17]. Nonetheless, none of these studies compared the predictivity of plasma NT-proBNP level for mortality with different follow-up periods among the same participant setting in the single study.…”

Association between elevated adiponectin level and adverse outcomes in patients with heart failure: a systematic review and meta-analysis

“…Adiponectin, an adipocyte-specific cytokine, exhibits anti-inflammatory property and protective effects against obesity-related diseases (6). Circulating adiponectin level was increased in patients with heart failure irrespective of etiologies (7 –9), implying substantial potential as a prognostic biomarker. However, adiponectin appears to lose its cardio-protective and anti-inflammatory properties in heart failure patients (10).…”

The Role of Cardiac T-Cadherin in the Indicating Heart Failure Severity of Patients with Non-Ischemic Dilated Cardiomyopathy

“…Even more, a positive association between inflammation and APN is usually reported in chronic HF [23]. Higher levels of circulating APN are also linked to the poor outcome of patients with chronic HF [24][25][26][27]. It is still questionable if APN loses its anti-inflammatory and cardioprotective activity in chronic HF, or the compensatory increase of APN in serum is unable to counteract the increasing pro-inflammatory milieu [5].…”