Adiponectin acts as a positive indicator of left ventricular diastolic dysfunction in patients with hypertrophic cardiomyopathy

Background: Adiponectin is an adipose-derived plasma protein that exhibits beneficial actions on the heart. Recently, it was shown that adiponectin levels were elevated in patients with systolic heart failure. Objective: To investigate the association between adiponectin levels and left ventricular (LV) diastolic function in patients with hypertrophic cardiomyopathy (HCM), characterised by diastolic dysfunction. Methods: Twenty-six patients with HCM showing LV ejection fraction of >60% were enrolled. LV pressure half-time (T_1/2) was measured as an index of myocardial relaxation. Patients were divided into two groups on the basis of baseline T_1/2 (group A: T_1/2< 35 ms, group B: T_1/2≥ 35 ms). Blood samples were simultaneously collected from the coronary sinus (CS) and aortic root (Ao) as well as the peripheral vein (PV) for measurement of plasma adiponectin levels. Results: Plasma adiponectin levels were significantly higher in group B than in group A. Adiponectin levels in the PV were positively correlated with the baseline T _1/2 in patients with HCM. The transcardiac gradient of adiponectin as calculated by the Ao-CS difference was significantly higher in group A than in group B. The transcardiac gradient of adiponectin also inversely correlated with the baseline T_1/2 and adiponectin levels in PV in patients with HCM. The expression of AdipoR1 but not AdipoR2 in the heart decreased in group B. The baseline T_1/2 was negatively associated with AdipoR1 expression in patients with HCM. Conclusions: These data document that adiponectin is an indicator of LV diastolic dysfunction in patients with HCM.