TY - JOUR
T1 - HFpEF and HFrEF exhibit different phenotypes as assessed by leptin and adiponectin
AU - Faxén, Ulrika Ljung
AU - Hage, Camilla
AU - Andreasson, Anna
AU - Donal, Erwan
AU - Daubert, Jean Claude
AU - Linde, Cecilia
AU - Brismar, Kerstin
AU - Lund, Lars H.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Background Heart failure with reduced ejection fraction (HFrEF) exhibits a “reverse metabolic profile”. Whether this profile exists in HF with preserved ejection fraction (HFpEF) is unknown. We tested the hypothesis that HFpEF and HFrEF are similar regarding concentrations of and prognostic impact of leptin and adiponectin. Methods In patients with HFpEF(n = 79), HFrEF(n = 84), and controls(n = 71), we analyzed serum leptin and adiponectin concentrations, their correlations, and associations with outcome. Results Leptin levels in HFpEF and HFrEF were increased (p < 0.05) compared to controls; with the highest levels in HFpEF, median (IQR), 23.1 (10.2–51.0), vs. HFrEF 15.0 (6.2–33.2), and vs. controls 10.8 (5.4–18.9) ng/mL.There was no difference between HFpEF and HFrEF p = 0.125 (adjusted for gender, BMI and age). Leptin was inversely associated with NT-proBNP (r = − 0.364 p = 0.001) and associated with better outcome in HFrEF (HR per ln increase of leptin 0.76, 95% CI 0.58–0.99, p = 0.044) but not in HFpEF. Crude levels of adiponectin were similar in HFpEF: 11.8 (7.9–20.1), HFrEF: 13.7 (7.0–21.1), and controls: 10.5 (7.4–15.1) μg/L. In men, adjusted similarly as leptin, there was no difference between HFpEF and HFrEF, p = 0.310 but, compared to controls, higher levels in HFpEF (p = 0.044) and HFrEF (p = 0.001). Adiponectin correlated positively with NT-proBNP; r = 0.396 p < 0.001 and higher levels were associated with adverse outcome only in HFrEF (HR per ln increase 2.88 (95% CI 1.02–8.14, p = 0.045). Conclusion HFpEF and HFrEF share elevated levels of leptin and adiponectin. However, the concept of reverse metabolic profile could not be confirmed in HFpEF, suggesting that HFpEF might have a conventional metabolic profile, rather than a distinct HF syndrome.
AB - Background Heart failure with reduced ejection fraction (HFrEF) exhibits a “reverse metabolic profile”. Whether this profile exists in HF with preserved ejection fraction (HFpEF) is unknown. We tested the hypothesis that HFpEF and HFrEF are similar regarding concentrations of and prognostic impact of leptin and adiponectin. Methods In patients with HFpEF(n = 79), HFrEF(n = 84), and controls(n = 71), we analyzed serum leptin and adiponectin concentrations, their correlations, and associations with outcome. Results Leptin levels in HFpEF and HFrEF were increased (p < 0.05) compared to controls; with the highest levels in HFpEF, median (IQR), 23.1 (10.2–51.0), vs. HFrEF 15.0 (6.2–33.2), and vs. controls 10.8 (5.4–18.9) ng/mL.There was no difference between HFpEF and HFrEF p = 0.125 (adjusted for gender, BMI and age). Leptin was inversely associated with NT-proBNP (r = − 0.364 p = 0.001) and associated with better outcome in HFrEF (HR per ln increase of leptin 0.76, 95% CI 0.58–0.99, p = 0.044) but not in HFpEF. Crude levels of adiponectin were similar in HFpEF: 11.8 (7.9–20.1), HFrEF: 13.7 (7.0–21.1), and controls: 10.5 (7.4–15.1) μg/L. In men, adjusted similarly as leptin, there was no difference between HFpEF and HFrEF, p = 0.310 but, compared to controls, higher levels in HFpEF (p = 0.044) and HFrEF (p = 0.001). Adiponectin correlated positively with NT-proBNP; r = 0.396 p < 0.001 and higher levels were associated with adverse outcome only in HFrEF (HR per ln increase 2.88 (95% CI 1.02–8.14, p = 0.045). Conclusion HFpEF and HFrEF share elevated levels of leptin and adiponectin. However, the concept of reverse metabolic profile could not be confirmed in HFpEF, suggesting that HFpEF might have a conventional metabolic profile, rather than a distinct HF syndrome.
KW - adiponectin
KW - leptin
KW - heart failure with preserved ejection fraction
KW - adipocytokines
KW - heart failure
KW - biomarker
UR - http://www.scopus.com/inward/record.url?scp=84996598813&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2016.11.194
DO - 10.1016/j.ijcard.2016.11.194
M3 - Article
C2 - 27886615
AN - SCOPUS:84996598813
SN - 0167-5273
VL - 228
SP - 709
EP - 716
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -