Abstract 10858: High Plasma Adiponectin Level is Associated With Clinical Severity and Unexpected Clinical Events in Patients After the Fontan Operation
Background: A high plasma adiponectin level (APN) associates with high morbidity and mortality in heart failure patients. No data have been available for the clinical relevance of APN in patients after the Fontan operation. Objectives: Our study was to clarify the clinical relevance of APN in Fontan patients.
Methods: Since 2005, we measured APN in 166 Fontan patients (19 ± 7 years with the postoperative follow-up of 11 ± 6 years) and 28 controls and compared the results with the clinical findings, including hemodynamics, plasma brain natriuretic peptide level (BNP), biochemical markers, peak oxygen uptake (pVO2), and clinical events that required hospitalization.
Results: The Fontan patients showed a higher APN (19.8 ± 10.0 vs. 12.8 ± 6.4, p < 0.001). In the Fontan patients, Age, the body mass index (BMI), New York Heart Association class (NYHA) central venous pressure, aortic pressure, arterial oxygen saturation, log BNP, plasma glucose level (BS), log triglyceride (TG), low-density lipoprotein, albumin, alanine transaminase (ALT), and pVO2 were associated with the APN (|r| = 0.18 - 0.37, p < 0.05 - 0.0001). Of those, BMI, NYHA class, log BNP, albumin, and log TG independently predicted the APN. Forty-eight clinical events occurred during the mean follow-up of 2.3 years and the Cox proportional hazards model revealed that the high APN and greater NYHA class independently predicted unexpected hospitalization (p < 0.05 for both).
Conclusions: The close association of high APN with the clinical severity implies an importance of heart failure-associated metabolic abnormality in Fontna circulation.
- © 2012 by American Heart Association, Inc.