HFpEF and HFrEF exhibit different phenotypes as assessed by leptin and adiponectin

Area of Science:

• Cardiology
• Metabolic Syndrome
• Biomarkers

Background:

• Heart failure with reduced ejection fraction (HFrEF) is characterized by a "reverse metabolic profile."
• It remains unknown if heart failure with preserved ejection fraction (HFpEF) shares this metabolic profile.
• This study investigates similarities in leptin and adiponectin concentrations and prognostic impact between HFpEF and HFrEF.

Purpose of the Study:

• To compare serum leptin and adiponectin levels in patients with HFpEF, HFrEF, and healthy controls.
• To determine the correlation of these adipokines with clinical markers like NT-proBNP.
• To assess the prognostic significance of leptin and adiponectin in HFpEF and HFrEF outcomes.

Main Methods:

• Serum samples from 79 HFpEF patients, 84 HFrEF patients, and 71 controls were analyzed.
• Concentrations of leptin and adiponectin were measured.
• Statistical analyses included correlations and survival analyses (Cox proportional hazards models).

Main Results:

• Leptin levels were elevated in both HFpEF and HFrEF compared to controls, with the highest levels observed in HFpEF.
• Adiponectin levels were similar across HFpEF, HFrEF, and controls, but higher in men with HFpEF and HFrEF versus male controls.
• Leptin was inversely associated with NT-proBNP and predicted better outcomes in HFrEF, while adiponectin correlated positively with NT-proBNP and predicted adverse outcomes in HFrEF.

Conclusions:

• Both HFpEF and HFrEF exhibit elevated leptin and adiponectin levels.
• The "reverse metabolic profile" characteristic of HFrEF was not confirmed in HFpEF.
• Findings suggest HFpEF may possess a conventional metabolic profile, distinct from HFrEF's unique metabolic syndrome.