Relations of Apelin with Cardiac Remodeling in Patients with Hypertension and Type 2 Diabetes

Abstract

BACKGROUND: The peptide apelin has antihypertensive and antidiabetic properties, but its role in the processes of cardiac remodeling in patients with hypertension and type 2 diabetes (T2D) is poorly understood. AIM: The aim of the study was to investigate apelin levels in patients with hyper-tension and T2D and to determine its relations to heart structural parameters and types of cardiac remodeling. MATERIALS AND METHODS: We examined 63 patients with hypertension and T2D. Investigation complex included physical examination, standard transthoracic echocardiography and determination of apelin serum levels by ELISA. Control group consisted of 16 volunteers. RESULTS: The apelin levels in patients were significantly lower than those in volunteers (0.882(0.788; 0.924) ng/ml versus 1.097(0.944; 1.171) ng/ml, p<0.001). Negative correlation relations of apelin with septal wall thickness (r=-0.50, p<0.001), posterior wall thickness (r=-0.46, p<0.001), left ventricle (LV) mass (r=-0.39, p<0.01), LV mass index (r=-0.42, p<0.001) and left atrium size (r=-0.45, p<0.001) were found. In patients with concentric remodeling of LV apelin levels were 0.918 (0.892; 0.984) ng/ml, with concentric LV hypertrophy - 0.855(0.722; 0.899) ng/ml, with eccentric LV hypertrophy - 0.884(0.856; 0.929) ng/ml (p<0.05, p<0.001, p<0.001 versus control, respectively). Patients with concentric LV hypertrophy had significantly lower apelin levels than patients with concentric remodeling of LV (p<0.05). CONCLUSION: Patients with hypertension and T2D have significant reduction of apelin blood levels, which is accompanied by cardiac remodeling development primarily concentric LV hypertrophy and have negative correlation relations of apelin with heart structural parameters that characterize LV remodeling and left atrium size.