Adiponectin is associated with abnormal lipid profile and coronary microvascular dysfunction in patients with dilated cardiomyopathy without overt heart failure

Abstract

Reduced plasma adiponectin has been associated with abnormal lipid profile, reduced left ventricle (LV) function, and the extent of coronary atherosclerosis in coronary artery disease. The aim of this study was to assess these relationships in patients with dilated cardiomyopathy (DCM) without overt heart failure. Plasma adiponectin was measured in 55 DCM patients (age, 59 ± 12 years; male, 36; body mass index [BMI], 26.9 ± 0.49 kg/m²; LV ejection fraction, 39.8% ± 1.3%; New York Heart Association class I-II) and in 40 age- and BMI-matched healthy controls. In a subset of 25 patients, myocardial blood flow (MBF) was measured at rest and during intravenous dipyridamole (0.56 mg/kg in 4 minutes) by positron emission tomography and ¹³N-ammonia as a flow tracer. Adiponectin was 6.6 ± 0.34 μg/mL in controls and 10.9 ± 0.85 μg/mL in DCM patients (P < .001), where it was related inversely with BMI (P = .009) and directly with brain natriuretic peptide (P = .017), high-density lipoprotein (HDL) cholesterol (P = .002), and MBF dipyridamole (P = .020). Adiponectin lesser than median value in patients was associated with higher total to HDL cholesterol ratio (4.8 ± 0.24 vs 3.9 ± 0.18, P = .009) and lower MBF reserve (1.76 ± 0.16 vs 2.43 ± 0.19, P = .01). These results could suggest that down-regulation of the adiponectin levels and reduced HDL cholesterol have a key role in causing impaired coronary function and myocardial perfusion in DCM.

Fig. 1

Myocardial blood flow variables in DCM patients and in controls. Myocardial blood flow b (A), MBF dip (B), and MBF reserve (C) are significantly reduced in DCM patients with respect to controls [16].

Fig. 2

Relationship between adiponectin, and metabolic and MBF variables. In patients with DCM, adiponectin correlates negatively with BMI (A), and positively with HDL cholesterol (B) and MBF dip (C). Logarithmic transformation of the original values was performed when variables were not normally distributed.

Fig. 3

Myocardial blood flow and adiponectin. Myocardial blood flow b (top), MBF dip (middle), and MBF reserve (bottom) are severely reduced in patients of group 1 (ie, with adiponectin lower than the median value, 9.1 μg/mL; interquartile range, 7.625) with respect to patients of group 2 (ie, with adiponectin higher than the median value). Mean values and SEM are shown.