Abstract: Objective To explore the effectof phosphorylated AMPK and adiponectinresistance on valvular heart disease（VHD） complicated with cardiac insufficiency. Methods A total of 47 VHD inpatients were selected as VHD group，33 cases of cardiac trauma as experimental control，and 50 healthy personsas normal group. ELISA was used to detect the serum adiponectin（APN），tumor necrosis factor-α （TNF-α） and brain natriuretic peptide（BNP）. A small amount of myocardial tissue specimenswas collected bybiopsy in the patients and control group，respectively. APN mRNA expression in cardiac tissue was detected by real time quantitative PCRand APN，AMPK and phosphorylated AMPK （pAMPK） expressions in cardiac muscle tissuesweredetected by Western blotting. Results The serum levels of APN，TNF-α，BNP in VHD group were significantly higher than those in the control and normal group （P<0.05）; serum APN，TNF-α，BNP in control group were obviouslyhigher than thosein normal group （P<0.05）. The myocardial fibers in the tissues of VHDgroup were found to beirregular，with a high expression of APN mRNA and protein （P<0.05）.The expression of pAMPK in VHD group was notablylower than that in the control （P<0.05）. No significant difference of AMPK expressionbetween the VHDpatients and the control （P>0.05）. Conclusion Patients with VHD combined with cardiac insufficiencyshowed increasedserumAPN，TNF-α and BNP but decreasedphosphorylated AMPK，and the APN resistance of myocardial tissuesmay occur，leading to the failure of APN-mediated myocardial protection.

Key words: pAMPK Adiponectin resistance , Valvulopathy, Cardiac insufficiency, Myocardial protection