Adiponectin a Potential New Biomarker of Congenital Heart Disease in PH

High levels of the peptide adiponectin show potential as a biomarker for the prognosis of congenital heart disease in patients with pulmonary hypertension (PH), according to a recent study.

Titled “High plasma adiponectin is associated with increased pulmonary blood flow and reduced right ventricular function in patients with pulmonary hypertension,” the study was published in the journal BMC Pulmonary Medicine.

If left undetected, PH can lead to serious cardiac conditions like right heart failure, in which the right side of the heart fails to adequately pump blood into the lungs. Although this complication is treatable if caught early, many patients do not show early symptoms, raising the need for a biomarker that can help physicians in disease assessment.

The N-terminal pro-brain natriuretic peptide or NT-proBNP currently serves as the only validated and widely accepted prognostic marker of changes in cardiovascular function — also called hemodynamics — and survival in PH cases. Of note, high levels of NT-proBNP are associated with heart failure.

Recent studies, however, have suggested that adiponectin also correlates with NT-proBNP and heart failure.

But whether adiponectin correlates with hemodynamics in patients with congenital heart disease-associated pulmonary hypertension (CHD-PH) remains unknown.

To address this question, a team led by researchers at the Guangdong Cardiovascular Institute, in Guangzhou, China, evaluated 86 CHD-PH patients, with a mean age of 35.8 years. The team compared the levels of blood adiponectin and NT-proBNP to findings on echocardiograms and right heart catheterizations — two methods used to assess cardiac health.

In general, patients with CHD-PH had higher levels of adiponectin (mean 7.9 micrograms/ml) compared with data from healthy individuals (mean 3.61 micrograms/ml) treated at the same cardiovascular institute.

The adiponectin levels positively correlated with NT-proBNP, meaning that the higher the levels of adiponectin, the higher the levels of NT-proBNP.

The levels also were positively correlated with pulmonary blood flow and with declining right ventricular function. Increased pulmonary blood flow is thought to trigger the development of PH and therefore is recommended to be closely monitored.

Additionally, the researchers observed that adiponectin positively associated with the size of the right ventricle and negatively with its function. Those findings indicate that adiponectin might serve as an important indicator for the pulmonary-right ventricular system.

The study also showed that adiponectin’s diagnostic efficiency at detecting right ventricular impairment was not inferior to that of NT-proBNP “or even probably superior to NT-proBNP,” the researchers wrote.

Overall, “adiponectin levels were found to be positively correlated with the pulmonary circulation blood flow and negatively with the right ventricular function in patients with CHD-PH,” the researchers concluded.

According to the team, adiponectin “might be a valuable biomarker for assessing the hemodynamics and prognosis in CHD patients with PH.”

However, the investigators said “knowledge gaps remain and further investigation is warranted.”