title: High leptin and resistin expression in chronic heart failure: adverse outcome in patients with dilated and inflammatory cardiomyopathy.
abstract: OBJECTIVE
  The expression of leptin and resistin is known to be positively correlated with the incidence of chronic heart failure (CHF). Both adipokines have been implicated in immunomodulation and cardiac remodelling. Therefore, we performed for the first time a clinical study to elucidate the effects of leptin and resistin on progression of CHF in patients with non-ischaemic dilated (DCM) and inflammatory (DCMi) cardiomyopathy.
  
  
  RESULTS
  For the clinical study 120 patients were divided into a control (n = 16), DCM (n = 52), and DCMi (n = 52) group to determine the effect of leptin and resistin on CHF progression. Nuclear factor-κB (NF-κB) activation, reactive oxygen species generation, and tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) expression following adipokine exposition were determined in vitro in cardiomyocytes. Leptin and resistin systemic plasma levels and not cardiac expression were significantly elevated in patients with DCM (leptin, 13.12 ± 17.2 ng/mL, P < 0.05; resistin, 6.87 ± 2.25 ng/mL, P < 0.05) and DCMi (leptin, 13.63 ± 16 ng/mL, P < 0.05; resistin, 7.27 ± 2.2 ng/mL, P < 0.05) compared with the control group (leptin, 7.34 ± 5.7 ng/mL; resistin, 4.4 ± 1.18 ng/mL). A multivariate linear regression model revealed low leptin and resistin plasma levels as contributors for favourable cardiac functional parameters at 6-month follow-up independent of inflammatory conditions. Cell culture experiments in vitro showed leptin and resistin to be potent regulators of TNF-α and IL-6 expression in cardiomyocytes, leading to significantly increased redox stress in cardiac cells.
  
  
  CONCLUSIONS
  High leptin and resistin expression in patients with DCM and DCMi is associated with CHF progression, i.e. severe cardiac dysfunction, independent of immune responses.
authors: Department of Cardiology and Pneumology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Germany.
authors: Peter
authors: P
authors: Bobbert
authors: Alexander
authors: A
authors: Jenke
authors: Thomas
authors: T
authors: Bobbert
authors: Uwe
authors: U
authors: Kühl
authors: Ursula
authors: U
authors: Rauch
authors: Dirk
authors: D
authors: Lassner
authors: Carmen
authors: C
authors: Scheibenbogen
authors: Wolfgang
authors: W
authors: Poller
authors: Heinz-Peter
authors: HP
authors: Schultheiss
authors: Carsten
authors: C
authors: Skurk
mesh_terms: D000328:Adult; D015415:Biomarkers; D009202:Cardiomyopathies / Q000188:drug therapy* / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000473:pathology; D020738:Leptin / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012372:ROC Curve; D052243:Resistin / Q000096:biosynthesis* / Q000097:blood; D013223:Statistics as Topic; D013318:Stroke Volume; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left
chemical_list: D015415:Biomarkers; D020738:Leptin; D052243:Resistin