Abstract:
BACKGROUND:Circulating high-density lipoprotein particle (HDL-P) subfractions impact atherogenesis, inflammation, and endothelial function, all of which are implicated in the pathobiology of heart failure (HF). OBJECTIVES:The authors sought to identify key differences in plasma HDL-P subfractions between patients with HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) to determine their prognostic utility. METHODS:Patients with HFrEF (n = 782), HFpEF (n = 1,004), and no HF (n = 4,742) were identified in the CATHGEN (Catheterization Genetics) biorepository of sequential patients undergoing cardiac catheterization. Nuclear magnetic resonance-based lipoprotein profiling was performed on frozen fasting plasma obtained at catheterization. The authors used multivariable analysis of covariance to compare high-density lipoprotein particle (HDL-P) subfractions across groups, and Cox proportional hazards modeling to determine associations between HDL-P subfractions and time to death or major adverse cardiac events. RESULTS:Mean HDL-P size was greater in HFrEF than HFpEF, both of which were greater than in no HF (all 2-way p < 0.0001). By contrast, concentrations of small HDL-P and total HDL-P were lesser in HFrEF than HFpEF, which were both lesser than no HF (all 2-way p ≤ 0.0002). In both HFrEF and HFpEF, total HDL-P and small HDL-P were inversely associated with time to adverse events. These findings persisted after adjustment for 14 clinical covariates (including high-density lipoprotein cholesterol content, coronary artery disease, and the inflammatory biomarker GlycA), and in sensitivity analyses featuring alternate left ventricular ejection fraction definitions, or stricter inclusion criteria with diastolic dysfunction or left ventricular end-diastolic pressure thresholds. CONCLUSIONS:In the largest analysis of HDL-P subfractions in HF to date, derangements in HDL-P subfractions were identified that were more severe in HFrEF than HFpEF and were independently associated with adverse outcomes. These data may help refine risk assessment and provide new insights into the complex interaction of HDL and HF pathophysiology.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Hunter WG,McGarrah RW 3rd,Kelly JP,Khouri MG,Craig DM,Haynes C,Felker GM,Hernandez AF,Velazquez EJ,Kraus WE,Shah SHdoi
10.1016/j.jacc.2018.10.059subject
Has Abstractpub_date
2019-01-22 00:00:00pages
177-186issue
2eissn
0735-1097issn
1558-3597pii
S0735-1097(18)39181-2journal_volume
73pub_type
杂志文章abstract:OBJECTIVES:Our aim was to clarify the anatomic substrate in hearts diagnosed as having tricuspid atresia by studying autopsy specimens and comparing the findings with those in two-dimensional echocardiograms. BACKGROUND:Traditionally, tricuspid atresia was thought, and is still believed by some, to be due to an imperf...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00250-8
更新日期:1995-09-01 00:00:00
abstract::Diabetes mellitus is one of the most common chronic medical conditions, and is a risk factor for the development of atrial fibrillation (AF). The presence of diabetes in patients with AF is associated with increased symptom burden and increased cardiovascular and cerebrovascular mortality. The pathophysiology of diabe...
journal_title:Journal of the American College of Cardiology
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更新日期:2020-12-22 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(83)80209-5
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更新日期:2014-07-15 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-06-01 00:00:00
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更新日期:2012-04-10 00:00:00
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更新日期:2012-12-25 00:00:00
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