Effect of Carperitide on Plasma Adiponectin Levels in Acute Decompensated Heart Failure Patients With Diabetes Mellitus

BACKGROUND: It is reported that adiponectin has a cardioprotective effect and is decreased in type 2 diabetes mellitus (DM). METHODS AND RESULTS: The effect of carperitide (atrial natriuretic peptide: ANP) on plasma adiponectin levels was evaluated in acute decompensated heart failure (ADHF) patients with and without DM. In 47 patients (DM: n=11) who were admitted with ADHF, blood samples were collected before and 7 days after administration of carperitide. The plasma levels of ANP, brain natriuretic peptide (BNP), aldosterone and adiponectin were measured. Plasma adiponectin levels were significantly increased (17.6 +/-1.5 to 19.6 +/-1.8 microg/ml, P=0.0003) concomitant with the increase in ANP and decrease in BNP 7 days after carperitide infusion. Although adiponectin levels before treatment were slightly lower in ADHF patients with DM, the % increase in adiponectin levels was significantly greater in ADHF patients with DM than in those without DM (26.7 vs 6.6%, P=0.007). In the stepwise multivariate analyses, a higher plasma aldosterone levels before treatment (P=0.04) and DM (P=0.01) were significant independent predictors of a greater % increase in adiponectin levels after treatment with carperitide. CONCLUSIONS: Carperitide infusion increases the plasma adiponectin level, especially in ADHF patients with DM.