Abstract 836: Impact of Hypoadiponectinemia on Left Ventricular Remodeling after Primary Coronary Intervention for Acute Myocardial Infarction
Left ventricular (LV) remodeling after acute myocardial infarction (AMI) is a precursor of the development of overt heart failure and is an important predictor of mortality. Adiponectin (AN) is an adipose-derived plasma protein that has the cardio-protective role against ischemia-reperfusion injury. Altered activity of matrix metalloproteinase (MMP) family has been implicated in the development of LV remodeling after myocardial infarction. Serum AN levels affect MMPs and tissue inhibitor of MMP (TIMP) levels, and attenuate adverse LV remodeling after AMI. In 88 consecutive patients with AMI successfully treated with primary percutaneous coronary intervention (PCI), serum levels of AN, MMP-2, MMP-9, and TIMP-1 were measured on admission, at day 7, and at 6 months after the onset. LV end-diastolic volume index (EDVI) and ejection fraction (EF) were assessed with 99m−Tc-tetrofosmin quantitative gated single-photon emission computed tomography within 10 days (early) and six months (chronic) after the onset. Serum AN and MMP-2 levels were decreased and serum MMP-9 and TIMP-1 levels were increased at day 7 compared to those at the onset and 6 months. Chronic/early EDVI ratio was negatively correlated with log AN at day 7 (r= −0.265, p=0.013), log AN at 6 months (r= −0.335, p=0.008), log MMP-2 at day 7 (r= −0.229, p=0.042), and positively correlated with log MMP-9 at day 7 (r= 0.237, p=0.037), log TIMP-1 on admission (r=0.277, p=0.0408). Chronic EF was positively correlated with log AN at day 7 (r=0.225, p=0.0374) and negatively correlated with log TIMP-1 at day 7 (r= −0.281, p=0.0133). Multiple logistic regression analyses revealed that chronic/early EDVI ratio independently correlated with log AN (r= −0.249, p=0.034) at day 7, although Log AN correlated positively log MMP-2, and negatively with log MMP-9 both at day 7 and 6 months. Measurement of AN at subacute phase can predict adverse cardiac remodeling in patients with AMI successfully treated with PCI.