Adiponectin Levels In Valvular Heart Disease And Adiponectin Resistance On The Impact Of Valvular Heart Disease

Valvular heart disease is common in rheumatic heart disease, early occult disease, a history of long gradual progress can lead to myocardial damage, decreased heart function, and chronic heart failure. Chronic heart failure is usually accompanied neuroendocrine and cytokine activation. Including adiponectin(APN), brain natriuretic peptide(BNP), Tumor necrosis factor-alpha-α(TNF-α), activation of these cytokines are correlated with chronic heart failure, valvular disease has not been caused by know. Adiponectin is an important cytokine secreted by fat cells, with the protection of the ischemic myocardium, protecting endothelial cells, regulation of energy metabolism and anti-inflammatory effects. Adiponectin resistance refers to peripheral target tissues of adiponectin sensitivity and reactivity decreased, resulting in physiological doses produce physiological effects of adiponectin is lower than normal. There are two main adiponectin receptors, Adipo R1 and Adipo R2.Adipo R1 mainly distributed in vascular endothelial cells and smooth muscle cells and cardiac myocytes, Adipo R2 is mainly distributed in the liver tissue. Multiple clinical studies have found that adiponectin levels than normal in patients with heart failure increased, while fat adiponectin levels corresponding myocardial protective effect does not appear. A preliminary study of patients with heart failure found in skeletal muscle cells, Adipo R1 and AMPK signaling pathways downstream obstacles, is led to the phenomenon of adiponectin main reason for resistance. This study by adiponectin and downstream signaling function of heart failure caused by valvular heart disease in patients with myocardial tissue activity of AMPK pathway to further confirm the presence of myocardial tissue may speculate that adiponectin resistance, and to explore its mechanisms. Objective: Explore the relationship between valvular heart disease adiponectin(APN), brain natriuretic peptide(BNP)、Tumor necrosis factor-alpha-α(TNF-α) levels and between each other. Valvular heart disease in patients with myocardial whether adiponectin resistance(adiphe resistance) phenomenon, and adiponectin resistance to the impact of valvular heart disease and related resistance mechanisms. Methods:(1) 78 patients under CPB valvular heart valve replacement surgery was the treatment group, 70 cases of healthy chenck patients was the control group. Fasting venous blood collected in 5 m L, plasma was separated and placed in the 4 m L of plasma centrifuge tube for the determination of APN, BNP,TNF-α, were placed in a-80 cryogenic refrigerator, the same batch of samples to be measured after complete. ℃APN and BNP 、 TNF-αmeasured by ELISA; were compared serum APN, BNP, TNF-αlevels and between radioimmunoassay;(2) 36 patients under CPB valvular heart valve replacement surgery was the treatment group, 22 cases of heart transplant donors and patients need heart surgery trauma was the control group. When the establishment of cardiopulmonary bypass, myocardial tissue collected were cut off. Results:(1) Compared with the control group, patients with valvular elevated adiponectin plasma APN, BNP, TNF-αlevels were significantly higher(P <0.01);(2) Compared with the control group, patients with cardiac valvular tissue was significantly higher in expression of adiponectin m RNA expression(P <0.01), the downstream pathways in patients with cardiac valvular tissue AMPK phosphorylation levels were significantly lower(P <0.05). Histopathology results comply with the appropriate cardiac function of myocardial performance. Conclusion:(1) This study showed that the group APN, BNP, TNF-αhigher, indicating chronic heart failure caused by valvular heart disease, there are a variety of process excessive activation of neuroendocrine factors; APN and BNP, TNF-αwas positively correlated BNP possibly through c-GMP-dependent pathway, promote secretion of APN; APN and TNF-α was positively correlated to inhibition of the inflammatory response, TNF-αmay promote the secretion of anti-inflammatory effect of APN;(2) The tissue of patients with cardiac valvular disease’s adiponectin levels were significantly increased, but reduced adiponectin receptor AMP-activated protein kinase(AMPK) phosphorylation levels, as the high level of adiponectin can not play the protective effect of normal myocardium. Myocardial tissue of heart valves patients show adiponectin resistance.