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Increased leptin concentration has been associated with increased ventilatory drive in heart failure (HF) patients. However, in animal models a lack of leptin has also been associated with increased ventilatory drive. We hypothesized the relation of leptin concentration to exercise ventilation and ventilatory control is non-linear in HF patients.
Consecutive ambulatory HF patients were prospectively studied including measurement of serum leptin, BNP and ventilatory efficiency (VE/VCO2) by cardiopulmonary exercise testing. Subjects (n=58) were divided into quintiles by leptin concentration; 1st quintile leptin concentration (1.8 ± 0.9 ng/ml), 3rd as reference (10.8 ± 2.3 ng/ml) and 5th (33.3 ± 10.3 ng/ml). Mann-Whitney test and multiple regression were used for data analysis. Data are summarized as mean ± SD; beta coefficient; F ratio; p < 0.05 considered significant.
Peak exercise VE/VCO2 was significantly elevated in the lowest and in the highest leptin quintile compared to the reference quintile (Figure). Leptin concentration correlated inversely to VE/VCO2 in the 1st-3rd quintiles (b = −0.64; F = 4.2; p< 0 .01) and positively in the 3rd-5th quintiles (b = 0.52; F = 3.2; p= 0.02).
In HF patients, both high and low leptin serum concentrations are associated with impaired ventilatory efficiency suggesting a nonlinear U-shaped relation which may be caused by either low leptin concentration or leptin resistance when leptin concentration is high.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Novel and Standard Pharmacological Therapies in Heart Failure: Which Treatment for Which Patient
Abstract Category: 15. Heart Failure: Clinical
Presentation Number: 1221-289
- 2013 American College of Cardiology Foundation