Associations among plasma adiponectin, hypertension, left ventricular diastolic function and left ventricular mass index.

摘要

OBJECTIVE: The purpose of this study was to characterize the relationships among plasma adiponectin, essential hypertension, left ventricular diastolic function and left ventricular hypertrophy. METHODS AND RESULTS: Plasma adiponectin concentration was assessed by radioimmunoassay, and body mass index (BMI) was measured in 275 patients (138 women and 137 men). Various echocardiographic parameters such as deceleration time (DT) and isovolumetric relaxation time (IVRT) were measured by using echocardiograms. The authors calculated left ventricular mass index (LVMI) and E/A ratio. Pulse wave velocity (PWV) was calculated by dividing the distance between the left subclavian artery ostium and the tip of the femoral sheath with the time interval between two pulse waves. The plasma adiponectin concentration of the hypertensive group was significantly lower than that of the non-hypertensive group (9.9 +/- 9.8 microg/ml vs. 12.9 +/- 9.5 microg/ml, p = 0.019). PWV in the hypertensive group was 12.0 +/- 3.9 m/s compared with 9.3 +/- 2.8 m/s in the normotensive group (p < 0.001). LVMI in the hypertensive group was 135.1 +/- 35.4 g/m2 compared with 100.5 +/- 18.7 g/m2 in the normotensive group (p < 0.001). E/A ratio (0.8 +/- 0.3 vs. 1.1 +/- 0.4, p = 0.041) was lower in the hypertensive group. DT (200.0 +/- 61.2 ms vs. 177.3 +/- 40.8 ms, p = 0.048) and IVRT (106.9 +/- 25.4 vs. 91.3 +/- 27.6 ms, p = 0.243) were higher in the hypertensive group. Plasma adiponectin showed an inverse correlation with LVMI (r = -0.525; p < 0.001) and PWV (r = -0.557; p < 0.001), IVRT (r = -0.485; p = 0.008), and showed a positive correlation with E/A ratio (r = 0.359; p < 0.001). Multiple regression analyses showed that PWV and plasma adiponectin were able to explain the 73.3% of LVMI variability (r = 0.856; p < 0.001). CONCLUSION: The results suggest that a decrease in plasma adiponectin concentration is associated with the progression of left ventricular hypertrophy with diastolic dysfunction.