High plasma leptin levels are associated with impaired diastolic function in patients with coronary artery disease

•High leptin levels are associated with impaired LV diastolic function in CAD.•Leptin may be a mechanistic link between obesity and congestive heart failure.•Leptin may have profibrotic effects and increase collagen in myocardial ECM. Obese subjects have elevated leptin levels, which have been assoc...

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Published in:Peptides (New York, N.Y. : 1980) Vol. 84; pp. 17 - 21
Main Authors: Puurunen, V.P., Lepojärvi, E.S., Piira, O.P., Hedberg, P., Junttila, M.J., Ukkola, O., Huikuri, H.V.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.10.2016
Subjects:
Aged
Coronary artery disease
Coronary Artery Disease - blood
Coronary Artery Disease - etiology
Coronary Artery Disease - physiopathology
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - pathology
Diastole - physiology
Diastolic function
Echocardiography
Female
Heart failure
Heart Failure - blood
Heart Failure - physiopathology
Humans
Leptin
Leptin - blood
Male
Middle Aged
Obesity
Obesity - blood
Obesity - complications
Obesity - pathology
patients
risk
Risk Factors
tissues
Ventricular Dysfunction, Left - blood
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - physiopathology
Diastolic function
Heart failure
Obesity
Coronary artery disease
Leptin
ISSN:0196-9781, 1873-5169
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Summary:•High leptin levels are associated with impaired LV diastolic function in CAD.•Leptin may be a mechanistic link between obesity and congestive heart failure.•Leptin may have profibrotic effects and increase collagen in myocardial ECM. Obese subjects have elevated leptin levels, which have been associated with increased risk of cardiovascular events. Because leptin has direct cellular effects on various tissues, we tested the hypothesis that leptin levels are associated with cardiac structure or function in patients with coronary artery disease (CAD). The study population consisted of 1 601 CAD patients, of whom 42% had type 2 diabetes mellitus. Plasma leptin was measured in fasted state and an echocardiography performed. Leptin levels were not related to LV dimensions or LV ejection fraction (NS for all), but higher leptin levels were associated with elevated E/E’ (9.43 vs. 11.94 in the lowest and the highest leptin quartile, respectively; p=0.018 for trend). Correspondingly, a decreasing trend was observed in E/A (1.15 vs. 1.06; p=0.037). These associations were independent of obesity and other relevant confounding variables. We conclude that elevated plasma leptin levels are associated with impaired left ventricular diastolic function in patients with CAD independently of obesity and other confounding variables. Leptin may be one of the mechanistic links explaining the development of congestive heart failure in obese subjects.
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ISSN:0196-9781
1873-5169
DOI:10.1016/j.peptides.2016.08.002