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Adiponectin downregulation implicated in heart failure
9 March 2010
MedWire News: Levels of adiponectin are reduced in patients with both dilated cardiomyopathy (DCM) and impaired coronary function, study findings show.
These observations suggest that adiponectin downregulation may underlie the functional impairments seen in DCM and heart failure, suggest Daniela Giannessi (Research National Council, Pisa, Italy) and team.
Writing in the journal Metabolism Clinical and Experimental, Giannessi and co-authors report the results of their study assessing relationships among lipid profiles, coronary function, and coronary atherosclerosis. The study participants were 55 patients with DCM but without overt heart failure and 40 healthy controls matched for age and gender.
Among the DCM patients, the mean age was 59 years, mean body mass index (BMI) was 26.9 kg/m2, mean left ventricular ejection fraction was 39.8%, and all were in New York Heart Association class I or II.
Plasma adiponectin levels were higher in DCM patients than in controls, at 10.9 versus 6.6 µg/ml, a statistically significant difference.
In DCM patients, adiponectin levels were inversely correlated with BMI and positively correlated with brain natriuretic peptide, high-density lipoprotein (HDL) cholesterol, and myocardial blood flow (MBF) during intravenous dipyramidole infusion.
In addition, below-average adiponectin levels were associated with a higher total-to-HDL cholesterol ratio and a lower MBF reserve, indicating impaired myocardial perfusion.
Taken together, these results “strongly suggest that a relative downregulation of the adiponectin signal and reduced HDL cholesterol may be involved in the pathogenesis of coronary endothelial/microvascular dysfunction in DCM,” write Giannessi et al.
Noting that the antiatherosclerotic actions of adiponectin may be due to its effects of circulating lipids, and HDL cholesterol in particular, the authors conclude: “Because coronary endothelial/microvascular dysfunction has been recently recognized as a key pathogenetic factor of progressive left ventricular dysfunction not only in DCM but also in other cardiovascular disorders, the understanding of the pathogenetic mechanisms involved may reveal new therapeutic targets to prevent heart failure.”
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