Abstract 15071: Low Plasma Adiponectin Levels are Associated with Early Diastolic Dysfunction Independent of Obesity
Objective: Diastolic dysfunction (DD) with preserved ejection fraction has been previously linked to obesity and a lack of nitric oxide (NO) in the heart. Adiponectin is an adipocyte-derived cytokine that is inversely related to weight and is believed to modulate obesity-linked cardiac and vascular complications, in part by increasing NO. We aimed to determine the independent association of DD with adiponectin.
Methods: Twenty five consecutive patients with echocardiographically proven impaired relaxation DD and a normal systolic function, and 25 age-matched normal controls were recruited. Baseline demographic and clinical data were obtained at enrollment. Plasma levels of total and high molecular weight (HMW) adiponectin were measured in both groups. Mid and low molecular weight (MMW+LMW) fractions of adiponectin were calculated by subtracting HMW fraction from total adiponectin.
Results: The mean age of cases and controls was 64.8±10.8 and 65.0±11.3 years (p=0.96). The two groups were statistically similar in all demographic and clinical variables except for a higher number of males (18 (72%) versus 11 (44%), p <0.05) and higher BMI (mean, 29.6 ±4.8 versus 25.3±4.7, p= 0.003) among cases. Patients with DD had lower total adiponectin (median (IR), 4.4 (3.4–8.0) vs. 12.7 (6.2–18.7) μg/ml , p=0.001), lower HMW fraction of adiponectin (median (IR), 1.3 (0.04–3.4) vs. 3.4 (1.0–9.5) μg/ml , p=0.02), and lower MMW+LMW fraction of adiponectin (median (IR), 3.8 (2.7–5.1) vs. 7.2 (3.8–10.4)μg/ml, p=0.01). On multivariate regression, models using age, gender, BMI and study markers as covariates, DD retained an independent association with BMI (OR: 1.5, 95%CI: 1.1–2.2, p=0.01), total adiponectin (OR: 0.6, 95%CI: 0.4–0.8, p=0.001), HMW adiponectin (OR: 0.7, 95%CI: 0.5–0.9, p=0.02), and MMW+LMW adiponectin (OR: 0.7, 95%CI: 0.5–0.9, p=0.01).
Conclusions: Deficiency of adiponectin may be one explanation for the adiposity-related cardiac oxidation known to be involved in the pathogenesis of DD. Adiponectin levels may differentiate diastolic from systolic heart failure, and raising adiponectin may form a potential pharmacological target in DD.
- © 2010 by American Heart Association, Inc.