Evidence for decreased circulating apelin beyond heart involvement in uremic cardiomyopathy.
BACKGROUND
Plasma apelin concentration in heart failure has been described in small studies reporting conflicting results. In hemodialysis (HD) patients, apelin decreased more in those with more severe heart involvement. It is unclear if uremia is connected to this reduction irrespective of heart failure. We compared apelin in two cardiomyopathies with different renal function.


METHODS
Observational study conducted in 30 adult Caucasian outpatients in class I NYHA not affected by diabetes or ischemic heart, 15 with idiopathic dilated cardiomyopathy (DCM) and 15 with uremic dilated cardiomyopathy undergoing HD. Plasma apelin, creatinine, high-sensitivity C-reactive protein, endothelin, NT proB-type natriuretic peptide (NT-proBNP), and Doppler echocardiogram were evaluated.


RESULTS
Heart involvement was more severe in the DCM patients (lower ejection fraction, greater diastolic volume index, and worse index of myocardial performance). Median value of apelin in HD patients (19.1 pg/ml) was one third of that in DCM patients (58.2 pg/ml) whereas creatinine, NT-proBNP, and C-reactive protein were 11, 80, and 9 times higher respectively in HD than in DCM patients. Median values of endothelin were comparable in both groups. Apelin was not significantly correlated with any variable.


CONCLUSIONS
Uremic status was the determinant for decreased plasma apelin in HD patients regardless of the severity of heart involvement.
Codognotto
Marta
M
Division of Nephrology, University Hospital, University of Padova, Padova, Italy.
Piccoli
Antonio
A
Zaninotto
Martina
M
Mion
Monica
M
Vertolli
Ugo
U
Tona
Francesco
F
Boffa
Giovanni M
GM
D000328:Adult; D000368:Aged; D000073861:Apelin; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D015150:Echocardiography, Doppler; D016232:Endothelins / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008024:Ligands; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology; D014511:Uremia / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
C115436:APLN protein, human; D000073861:Apelin; D015415:Biomarkers; D016232:Endothelins; D036341:Intercellular Signaling Peptides and Proteins; D008024:Ligands; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D003404:Creatinine