• Laura Anido-Varela, Alana Aragón-Herrera, Adrián González-Maestro, Carlos Tilves Bellas, Estefanía Tarazón, Eduard Solé-González, Manuel Martínez-Sellés, José María Guerra-Ramos, Anna Carrasquer, Laura Morán-Fernández, David García-Vega, Ana Seoane-Blanco, María Moure-González, Jose Seijas-Amigo, Diego Rodríguez-Penas, Javier García-Seara, Sandra Moraña-Fernández, Xocas Vázquez-Abuín, Esther Roselló-Lletí, Manuel Portolés, Sonia Eiras, Rosa M Agra, Ezequiel Álvarez, José R González-Juanatey, Sandra Feijóo-Bandín, Francisca Lago, and REDINSCOR III registry.
• Cellular and Molecular Cardiology Research Unit, IDIS, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
• Eur. J. Clin. Invest. 2025 Jan 20: e14380e14380.

Background And AimsMeteorin-like protein (Metrnl) has been recently suggested as a new adipokine with protective cardiovascular effects. Its circulating levels in patients seem to be associated with heart failure (HF), although with contradictory results. Our aim was to ascertain whether this adipokine could estimate the prognosis of HF in de novo HF (DNHF) patients.MethodsMetrnl plasma levels of 400 patients hospitalized with DNHF (55% of patients with HF with reduced ejection fraction, 17.3% HF with mid-range ejection fraction, 27.8% HF with preserved ejection fraction) were measured by enzyme-linked immunosorbent assay. We performed both sex-pooled and sex-specific analyses. A 12-month follow-up was conducted, during which clinical outcomes such as all-cause mortality, cardiovascular death and re-hospitalization due to HF were collected.ResultsAfter a 12-month follow up, higher plasma Metrnl levels were associated with an increased risk for all-cause death and cardiovascular death after adjusting by sex, age, LVEF, hypertension, diabetes, ischemic aetiology, chronic renal failure, NT-proBNP and troponin (hazard ratio [HR] = 1.003, 95% confidence interval [CI] = 1.000-1.005; p-value<.05 and HR = 1.004, 95% CI = 1.001-1.007, p-value<.05, respectively). In line with this, DNHF patients with increased levels of circulating Metrnl had a higher number of occurrences of cardiovascular events. Regarding Metrnl associations with parameters implicated in the development and progression of HF, we found that Metrnl circulating levels were positively correlated with age (r = .322, p-value<.0001), NT-proBNP (r = .281, p-value<.0001) and with the renal dysfunction markers urea (r = .322, p-value<.0001) and creatinine (r = .353, p-value<.0001) and higher in women than men (473.7 [385.9-594.0] pg/mL vs. 428.7 [349.1-561.3] pg/mL, p-value<.006). Finally, concerning the subtype of HF, Metrnl plasma levels were higher in HF with preserved ejection fraction.ConclusionPatients with higher Metrnl levels have a worse prognosis in DNHF. Our results reinforce the association of Metrnl plasma levels with HF progression and outcomes.© 2025 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

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