Elevated adiponectin levels in patients with chronic heart failure: an independent predictor of mortality or a marker of cardiac cachexia?

Adiponectin may influence the development of chronic heart failure (CHF), but the epidemiological data are scarce. This is due in part to the fact that while higher BMIs are a risk factor for CHF, obesity is a predictor of improved prognoses in patients with CHF since wasting is strongly associated with the increased risk of death in the final stages of CHF. From that standpoint of view, high adiponectin levels are a predictor of mortality in patients with CHF. That paradoxical relationship may exist since high BMI, hence low adiponectin, favors survival in endstage heart failure. We strongly believe that further large-scale clinical studies are warranted to analyze independent prognostic significance of adiponectin levels in patients with CHF.