The Role of Serum Adiponectin for Outcome Prediction in Patients with Dilated Cardiomyopathy and Advanced Heart Failure

الملخص EN

Clinical interpretation of patients’ plasma adiponectin (APN) remains challenging; its value as biomarker in dilated cardiomyopathy (DCM) is equivocal.

We evaluated whether circulating APN level is an independent predictor of composite outcome: death, left ventricle assist device (LVAD) implantation, and heart transplantation (HT) in patients with nonischemic DCM.

57 patients with nonischemic DCM (average LV diastolic diameter 6.85 cm, LV ejection fraction 26.63%, and pulmonary capillary wedge pressure 22.06 mmHg) were enrolled.

Patients underwent echocardiography, right heart catheterization, and endomyocardial biopsy.

During a mean follow-up of 33.42 months, 15 (26%) patients died, 12 (21%) patients underwent HT, and 8 (14%) patients were implanted with LVAD.

APN level was significantly higher in patients who experienced study endpoints (23.4 versus 10.9 ug/ml, p=0.01).

APN was associated with worse outcome in univariate Cox proportional hazards model (HR 1.04, CI 1.02–1.07, p=0.001) but lost significance adjusting for other covariates.

Average global strain (AGS) is an independent outcome predictor (HR 1.42, CI 1.081–1.866, p=0.012).

Increased circulating APN level was associated with higher mortality and may be an additive prognostic marker in DCM with advanced HF.

Combination of serum (APN, BNP, TNF-α) and echocardiographic (AGS) markers may increase the HF predicting power for the nonischemic DCM patients.