• Adiponectin
• heart failure
• cytokines

Adiponectin is an adipocyte-derived cytokine that is abundantly present in human plasma.1 2 Adiponectin levels are highest in lean subjects, but levels decline as body mass increases. Work in experimental models has shown that adiponectin mediates beneficial actions in cardiovascular and metabolic-associated diseases. For example, in mouse models, adiponectin modulates hypertrophic signals in the heart and exhibits direct anti-hypertrophic properties; in addition to improving vascular function and pathological remodelling.3 4 Despite the agreement and consistency of experimental studies on adiponectin, a number of clinical findings have questioned the utility of this adipokine as a biomarker for human diseases. On one hand, depressed adiponectin levels have been associated with greater cardiovascular risk and inflammation since hypoadiponectinaemia occurs in coronary artery disease, hypertension and insulin resistance.5–8 On the other hand, high adiponectin levels are present in chronic inflammatory and autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, type 1 diabetes and inflammatory bowel disease independently of adiposity.9 In addition, chronic systolic heart failure is associated with elevated adiponectin levels.10–13 Now, Unno and colleagues report that adiponectin levels are elevated in non-obstructive hypertrophic cardiomyopathy (HCM) with diastolic dysfunction (see page 357).14

Hypertrophic cardiomyopathy (HCM), …