{"id":"d3b1c04e2dd8","type":"article","url":"https://hartvaat.nl/2026/05/26/adipokineprofiel-bij-acuut-hartfalen-voorspelt-natriuretische-respons-en-mortali/","title":"Adipokineprofiel bij acuut hartfalen voorspelt natriuretische respons en mortaliteit","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","ijzertekort","nt-probnp","step-hfpef","summit-trial","vrouwen"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag150","source_url":"https://doi.org/10.1093/eschf/xvag150","authors":["Jan Biegus","Rafał Tymków","Gracjan Iwanek","Robert Zymliński","Mateusz Guzik","Magdalena Hurkacz","Wojciech Sopyla","Piotr Gajewski","Piotr Ponikowski"],"significance":5,"published":"2026-05-30","source_date":"2026-05-26","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/arni-sacubitril-valsartan/","https://hartvaat.nl/kennis/hartfalen/diuretica-bij-hartfalen/"],"congress":"","summary_en":"Prospective observational study in 262 patients with acute heart failure, relating circulating adipokine profiles to the early natriuretic response (spot urine sodium 2 hours after intravenous loop diuretic). Patients with impaired response (uNa+ <90 mmol/L) had higher chemerin and FABP4 levels. An integrated adipokine score was independently associated with sodium excretion (β 3.37; 95% CI 1.51-5.23) and with 1-year mortality. FABP4 was consistently linked to both impaired natriuresis and adverse outcomes. The findings are hypothesis-generating and point to an adipo-inflammatory axis connecting diuretic response and prognosis.","created":"2026-07-03T10:32:58Z","updated":"2026-07-03T18:39:34Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Prospectieve observationele studie bij 262 patiënten met acuut hartfalen, waarin het circulerende adipokineprofiel werd gerelateerd aan de vroege natriuretische respons (urinair natrium 2 uur na intraveneuze lisdiuretica). Patiënten met een verminderde respons (uNa+ <90 mmol/L) hadden hogere spiegels van chemerine en FABP4. Een geïntegreerde adipokine-score was onafhankelijk geassocieerd met natriumexcretie (β 3,37; 95%-BI 1,51-5,23) en met 1-jaars mortaliteit. FABP4 toonde consistent associatie met zowel slechte natriurese als ongunstige uitkomsten. De resultaten zijn hypothese-genererend en wijzen op een adipo-inflammatoire route die diuretische respons en prognose verbindt.","abstract_original":"BACKGROUND: Adipose tissue signaling is linked to heart failure (HF), but its role in acute HF (AHF), especially concerning early diuretic response, is unclear. Early natriuretic response to loop diuretics is vital for effective decongestion. OBJECTIVES: To characterize and evaluate the associations between circulating adipokine profiles, early natriuretic response, and clinical outcomes in AHF. METHODS: We conducted a prospective observational study including 262 consecutive AHF patients. Early diuretic response was assessed by measuring post-diuretic spot urine sodium (uNa+) 2 hours after intravenous loop diuretic administration. Associations between adipokines and uNa+ were assessed, and an adipokine score was constructed based on markers associated with uNa+. Clinical outcomes (all-cause mortality and a composite of death or HF hospitalization) were evaluated over 1-year using Cox regression models. RESULTS: Patients with impaired natriuretic response (uNa+ <90 mmol/L) exhibited higher levels of selected Domain-3 adipokines, including chemerin and FABP4. Individual adipokines showed modest associations with early natriuretic response. Visfatin was significantly associated with lower post-diuretic uNa+, while IL-6, FABP4, and Adipsin demonstrated directional but non-significant trends. An adipokine score integrating these selected adipokines was independently associated with uNa+ after multivariable adjustment (β 3.37, 95% CI 1.51-5.23; p<0.001). During a 1-year follow-up, several adipokines: IL-6, resistin, and FABP4, were independently associated with mortality, while FABP4 consistently demonstrated associations with both impaired natriuresis and adverse outcomes. CONCLUSIONS: In AHF, individual adipokines are modestly associated with the early natriuretic response, whereas an integrated adipose-inflammatory profile shows a more consistent association with sodium excretion and adverse outcomes. These findings suggest that adipokine signaling may reflect biological pathways associated with diuretic response and prognosis, though the results should be considered hypothesis-generating."}