Adipokines and the Right Ventricle: The MESA-RV Study.
OBJECTIVE
Obesity is associated with changes in both right (RV) and left (LV) ventricular morphology, but the biological basis of this finding is not well established. We examined whether adipokine levels were associated with RV morphology and function in a population-based multiethnic sample free of clinical cardiovascular disease.


METHODS
We examined relationships of leptin, resistin, TNF-α, and adiponectin with RV morphology and function (from cardiac MRI) in participants (n = 1,267) free of clinical cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis (MESA)-RV study. Multivariable regressions (linear, quantile [25th and 75th] and generalized additive models [GAM]) were used to examine the independent association of each adipokine with RV mass, RV end-diastolic volume (RVEDV), RV end-systolic volume (RVESV), RV stroke volume (RVSV) and RV ejection fraction (RVEF).


RESULTS
Higher leptin levels were associated with significantly lower levels of RV mass, RVEDV, RVESV and stroke volume, but not RVEF, after adjustment for age, gender, race, height and weight. These associations were somewhat attenuated but still significant after adjustment for traditional risk factors and covariates, and were completely attenuated when correcting for the respective LV measures. There were no significant interactions of age, gender, or race/ethnicity on the relationship between the four adipokines and RV structure or function.


CONCLUSIONS
Leptin levels are associated with favorable RV morphology in a multi-ethnic population free of cardiovascular disease, however these associations may be explained by a yet to be understood bi-ventricular process as this association was no longer present after adjustment for LV values. These findings complement the associations previously shown between adipokines and LV structure and function in both healthy and diseased patients. The mechanisms linking adipokines to healthy cardiovascular function require further investigation.
Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
Michael O
MO
Harhay
Department of Medicine, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America.
Jorge R
JR
Kizer
Department of Family Medicine and Public Health, University of California San Diego, San Diego, California, United States of America.
Michael H
MH
Criqui
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
João A C
JA
Lima
Department of Laboratory Medicine, University of Vermont School of Medicine, Burlington, Vermont, United States of America.
Russell
R
Tracy
Radiology and Imaging Sciences, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health/Clinical Center, Bethesda, Maryland, United States of America.
David A
DA
Bluemke
Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
Steven M
SM
Kawut
D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005006:Ethnicity; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D020738:Leptin / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000473:pathology; D011859:Radiography; D052243:Resistin / Q000097:blood; D013318:Stroke Volume / Q000502:physiology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D052242:Adiponectin; D020738:Leptin; D052243:Resistin; D014409:Tumor Necrosis Factor-alpha