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European Heart Journal Advance Access published online on May 15, 2007
European Heart Journal, doi:10.1093/eurheartj/ehm154
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Total and high molecular weight adiponectin, haemodynamics, and mortality in patients with chronic heart failure

Takayoshi Tsutamoto*, Toshinari Tanaka, Hiroshi Sakai, Chitose Ishikawa, Masanori Fujii, Takashi Yamamoto and Minoru Horie

Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan

Received 9 December 2006; revised 30 March 2007; accepted 5 April 2007.

* Corresponding author. Tel: +81 77 548 2213; fax: +81 77 543 5839. E-mail address: tutamoto{at}belle.shiga-med.ac.jp

Aims: To evaluate whether plasma high molecular weight (HMW) adiponectin provides prognostic information in addition to that obtained from clinical, haemodynamic, and biochemical variables previously known to be associated with a high mortality in chronic heart failure (CHF) patients.

Methods and results: We measured the plasma levels of total and HMW adiponectin, atrial natriuretic peptide, brain natriuretic peptide (BNP), and N-terminal-proBNP (NT-proBNP), and haemodynamic parameters in 449 consecutive CHF patients. Based on body mass index (BMI), patients were classified into three groups: low (<21 kg/m2, n = 133), normal (21–25 kg/m2, n = 205), and high (>25 kg/m2, n = 111). After adjustment for clinical variables associated with CHF including haemodynamics, plasma total adiponectin level was an independent prognostic predictor but HMW adiponectin was not in the overall patient group. On subgroup analyses, in patients with abnormal BMI, plasma total adiponectin level was not an independent prognostic predictor, but in patients with normal BMI, plasma levels of log NT-proBNP (P = 0.017) and log total adiponectin (P = 0.003) were independent prognostic predictors.

Conclusion: These findings indicate that total adiponectin is more useful for assessing mortality risk than HMW adiponectin and a high plasma total adiponectin is an independent prognostic predictor especially in CHF patients with normal BMI.

Key Words: Adiponectin • Body mass index • N-terminal pro-brain natriuretic peptide • Prognosis • Heart failure


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