Aims:

Leptin has recently been associated to myocardial remodeling in animal experimentation studies on heart failure (HF). With the emergence of new medical therapies targeting cardiac remodeling, there needs to be a better understanding of metabolic pathways involving leptin. In addition, sex specific differences in leptin concentrations have been described. Our study aims at investigating gender- specific leptin’s correlation to heart failure parameters, as well as epicardial and pericardial adipose tissue (EAT and PAT) as potential paracrine origins of leptin.

Methods:

The study included 42 patients (13 women and 29 men) with chronic heart failure with reduced ejection fraction (HFrEF) of ischemic (n = 17) and non-ischemic (n = 25) origin (Table). Serum concentrations of leptin, NT-proBNP, HbA1c were measured. LV function parameters were assessed in transthoracic echocardiography, as well as EAT and PAT in parasternal long and short-axis views.

Results:

We found a significant gender difference in the serum concentration of leptin. We also found a positive correlation between leptin serum concentration and epicardial adipose tissue in women (EAT r=0.595, p=0.041) and between serum leptin concentration and pericardial adipose tissue in men (PAT r=0.417, p=0.031). Both EAT and PAT correlate negatively with the LV ejection fraction only in women (EAT r=-0.718, p=0.006; PAT r=-0.650, p=0.016). A positive correlation was further found between Leptin a NYHA class in men (r=0.575, p=0.001).

Conclusion:

We provide evidence of gender-specific serum leptin concentration in heart failure patients, as well its association with epicardial/pericardial fat tissue. The effect of leptin and adipose tissue on HFrEF and ist gender specificities require further investigation.