Is adiponectin elevation associated with left atrial remodeling and impaired mechanical functions? (a speckle tracking study)

Abstract

Objectives Recent studies demonstrated that elevated adiponectin levels predicted an increased risk of atrial fibrillation (AF) and stroke; however, a causal relationship is yet to be unknown. Reduced left atrium (LA) functions detected by two-dimensional echocardiographic speckle tracking (2D-STE) can predict AF development. We aimed to investigate the relationship between adiponectin level and LA functions in hypertensive and diabetic patients at high risk for incident AF.

Material and methods The study consisted of 80 hypertensive diabetic patients. All patients underwent echocardiography, and venous blood samples were taken. The relationship between adiponectin levels and LA functions was analyzed.

Results We divided patients into two groups according to the mean adiponectin level (13.63 ng/ml). In the high adiponectin group, the mean age (p=0.001) and high-density lipoprotein (HDL) cholesterol (p=0.015) were higher, whereas estimated glomerular filtration rate (eGFR) (p=0.036) and hemoglobin (p=0.014) levels were lower. Although LA maximum volume, LA minimum volume, and LA pre-A volume were higher in the group with high adiponectin levels, they did not reach a statistical significance. Peak early diastolic LA strain (S-LAe) (p=0.048) and strain rate (SR-LAe) (p=0.017) were lower in this group. Multivariate logistic regression analysis demonstrated that age (p=0.003) and hemoglobin (p=0.006) were predictors of elevated adiponectin levels. On the contrary, S-LAe, HDL cholesterol, and eGFR lost their statistical significance.

Conclusion In patients with HT and DM, elevated adiponectin level is associated with impaired LA mechanical functions. Increased age and hemoglobin level are independent predictors of elevated adiponectin levels.