Research Article The Role of Serum Adiponectin for Outcome Prediction in Patients with Dilated Cardiomyopathy and Advanced Heart Failure Vaida Baltr0nien{, 1 Daiva Bironait{, 2 Ieva KaDukauskien{, 1,3 Julius Bogomolovas, 1,4 Dalius Vitkus, 5 Kwstutis RuIinskas, 3 Edvardas Curauskas, 1 Renaldas Augulis, 1 and Virginija Grabauskien{ 1,3 1 Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, M. K. Ciurlionio 21, LT-03101 Vilnius, Lithuania 2 Department of Regenerative Medicine, State Research Institute, Center for Innovative Medicine, Santariskiu 5, LT-08406 Vilnius, Lithuania 3 Department of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariskiu 2, LT-08661 Vilnius, Lithuania 4 Department of Integrative Pathophysiology, Medical Faculty Mannheim, Mannheim, Germany 5 Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania Correspondence should be addressed to Vaida Baltr¯ unien˙ e; vaida.baltruniene@gmail.com Received 28 July 2017; Revised 25 October 2017; Accepted 29 October 2017; Published 26 November 2017 Academic Editor: Stefano Cagnin Copyright © 2017 Vaida Baltr¯ unien˙ e et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Clinical interpretation of patients’ plasma adiponectin (APN) remains challenging; its value as biomarker in dilated cardiomyopathy (DCM) is equivocal. We evaluated whether circulating APN level is an independent predictor of composite outcome: death, lef ventricle assist device (LVAD) implantation, and heart transplantation (HT) in patients with nonischemic DCM. 57 patients with nonischemic DCM (average LV diastolic diameter 6.85cm, LV ejection fraction 26.63%, and pulmonary capillary wedge pressure 22.06 mmHg) were enrolled. Patients underwent echocardiography, right heart catheterization, and endomyocardial biopsy. During a mean follow-up of 33.42 months, 15 (26%) patients died, 12 (21%) patients underwent HT, and 8 (14%) patients were implanted with LVAD. APN level was signifcantly higher in patients who experienced study endpoints (23.4 versus 10.9 ug/ml,  = 0.01). APN was associated with worse outcome in univariate Cox proportional hazards model (HR 1.04, CI 1.02–1.07,  = 0.001) but lost signifcance adjusting for other covariates. Average global strain (AGS) is an independent outcome predictor (HR 1.42, CI 1.081–1.866,  = 0.012). Increased circulating APN level was associated with higher mortality and may be an additive prognostic marker in DCM with advanced HF. Combination of serum (APN, BNP, TNF-) and echocardiographic (AGS) markers may increase the HF predicting power for the nonischemic DCM patients. 1. Introduction In recent years, the concept of chronic heart failure (CHF) pathogenesis has changed dramatically. It became clear that CHF is not simply a hemodynamic failure and even not a problem of impaired neuroendocrine activation; it is a far more complex process, a systemic disorder, which involves immune activation, metabolic alterations, and pathologic processes in skeletal muscle [1]. Adiponectin (APN) is an adipocyte-derived cytokine (adipokine), which is also synthesized in cardiac muscle cells and connective tissue cells within the heart [2]. APN has a critical signaling function in the heart which is particularly important in patients with heart failure. Its benefcial cardioprotective efects leave no doubt. APN has antiapoptotic, fbrosis reducing, and oxidative stress diminishing properties in myocardium [3, 4]. Lower serum APN is an independent cardiovascular risk factor in coronary Hindawi BioMed Research International Volume 2017, Article ID 3818292, 13 pages https://doi.org/10.1155/2017/3818292