1
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Huang X, Qiu J, Kuang M, Wang C, He S, Yu C, Xie G, Sheng G, Zou Y. Assessing the predictive value of the controlling nutritional status score on all-cause mortality during hospitalization in patients with acute decompensated heart failure: a retrospective cohort study from Jiangxi, China. Front Nutr 2024; 11:1392268. [PMID: 39036498 PMCID: PMC11258027 DOI: 10.3389/fnut.2024.1392268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024] Open
Abstract
Objective Nutritional status is closely associated with the prognosis of heart failure. This study aims to assess the relationship between the Controlling Nutritional Status (CONUT) score and in-hospital mortality among patients with acute decompensated heart failure (ADHF) in Jiangxi, China. Methods A retrospective cohort study was conducted. Multivariable Cox regression models and restricted cubic spline regression were employed to evaluate the relationship between the CONUT score and in-hospital mortality in ADHF patients from Jiangxi, China. The predictive value of the CONUT score for in-hospital mortality in ADHF patients was analyzed using receiver operating characteristic curves. Subgroup analyses were performed to identify risk dependencies of the CONUT score in specific populations. Results The study included 1,230 ADHF patients, among whom 44 (3.58%) mortality events were recorded. After adjusting for confounding factors, a positive correlation was found between the CONUT score and the risk of in-hospital mortality in ADHF patients. Restricted cubic spline regression analysis indicated a non-linear relationship between the CONUT score and the risk of in-hospital mortality in ADHF patients, estimating a rapid increase in mortality risk when the CONUT score exceeded 5. Receiver operating characteristic analysis demonstrated a good predictive value of the CONUT score for all-cause mortality events in ADHF patients [area under the curve = 0.7625, optimal threshold = 5.5]. Additionally, a relatively higher risk associated with the CONUT score was observed in male patients and those with concomitant cerebral infarction. Conclusion This study reveals a positive correlation between the CONUT score and the risk of in-hospital mortality in ADHF patients. Based on the findings of this study, we recommend maintaining a CONUT score below 5 for patients with ADHF in Jiangxi, China, as it may significantly contribute to reducing the risk of in-hospital all-cause mortality.
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Affiliation(s)
- Xin Huang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Jiajun Qiu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Maobin Kuang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Chao Wang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Shiming He
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Changhui Yu
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Guobo Xie
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Guotai Sheng
- Jiangxi Provincial Geriatric Hospital, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- Department of Cardiology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yang Zou
- Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
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2
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Zhao L, Zhao X, Tian P, Liang L, Huang B, Huang L, Feng J, Zhang Y, Zhang J. Predictive value of remnant cholesterol level for all-cause mortality in heart failure patients. Front Cardiovasc Med 2023; 10:1063562. [PMID: 36873397 PMCID: PMC9975541 DOI: 10.3389/fcvm.2023.1063562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/25/2023] [Indexed: 02/17/2023] Open
Abstract
Background Lower cholesterol levels are associated with increased mortality in heart failure (HF) patients. Remnant cholesterol corresponds to all cholesterol not found in high-density lipoprotein (HDL) and low-density lipoprotein (LDL). The prognostic role of remnant cholesterol in HF remains unknown. Objective To reveal the relationship between the baseline remnant cholesterol level and all-cause mortality in HF patients. Methods This study enrolled 2,823 patients hospitalized for HF. Kaplan-Meier analysis, Cox regression, C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the prognostic value of remnant cholesterol for all-cause mortality in HF. Results The mortality rate was lowest in the fourth quartile of remnant cholesterol, which had an adjusted hazard ratio (HR) for death of 0.56 [HR: 0.39, 95% confidence interval (CI): 0.46-0.68, p < 0.001] relative to the first quartile. After adjustment, a one-unit increase in the level of remnant cholesterol was associated with a 41% decrease in the risk of all-cause mortality (HR: 0.59, 95% CI: 0.47-0.73, p < 0.001). A refinement in risk prediction was observed after adding remnant cholesterol quartile to the original model (ΔC-statistic = 0.010, 95% CI: 0.003-0.017; NRI = 0.036, 95% CI: 0.003-0.070; IDI = 0.025, 95% CI: 0.018-0.033; all p < 0.05). Conclusion Low remnant cholesterol levels are associated with increased all-cause mortality in HF patients. The addition of the remnant cholesterol quartile improved the predictive value over traditional risk factors. Clinical Trial Registration ClinicalTrials.gov, Unique Identifier: NCT02664818.
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Affiliation(s)
- Lang Zhao
- Department of Emergency, China-Japan Friendship Hospital, Beijing, China.,State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuemei Zhao
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Pengchao Tian
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Liang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Boping Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liyan Huang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiayu Feng
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuhui Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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3
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Lavie CJ, daSilva-deAbreu A, Ventura HO, Mehra MR. Is There an Obesity Paradox in Cardiogenic Shock? J Am Heart Assoc 2022; 11:e026088. [PMID: 35658482 PMCID: PMC9238744 DOI: 10.1161/jaha.122.026088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Carl J Lavie
- John Ochsner Heart and Vascular InstituteOchsner Clinical School - The University of Queensland School of Medicine New Orleans LA
| | - Adrian daSilva-deAbreu
- Section of Cardiovascular Medicine Yale School of MedicineHeart and Vascular CenterYale-New Haven Hospital New Haven CT
| | - Hector O Ventura
- John Ochsner Heart and Vascular InstituteOchsner Clinical School - The University of Queensland School of Medicine New Orleans LA
| | - Mandeep R Mehra
- Brigham and Women's Hospital and Harvard Medical School Boston MA
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4
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Vignoli A, Fornaro A, Tenori L, Castelli G, Cecconi E, Olivotto I, Marchionni N, Alterini B, Luchinat C. Metabolomics Fingerprint Predicts Risk of Death in Dilated Cardiomyopathy and Heart Failure. Front Cardiovasc Med 2022; 9:851905. [PMID: 35463749 PMCID: PMC9021397 DOI: 10.3389/fcvm.2022.851905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background Heart failure (HF) is a leading cause of morbidity and mortality worldwide. Metabolomics may help refine risk assessment and potentially guide HF management, but dedicated studies are few. This study aims at stratifying the long-term risk of death in a cohort of patients affected by HF due to dilated cardiomyopathy (DCM) using serum metabolomics via nuclear magnetic resonance (NMR) spectroscopy. Methods A cohort of 106 patients with HF due to DCM, diagnosed and monitored between 1982 and 2011, were consecutively enrolled between 2010 and 2012, and a serum sample was collected from each participant. Each patient underwent half-yearly clinical assessments, and survival status at the last follow-up visit in 2019 was recorded. The NMR serum metabolomic profiles were retrospectively analyzed to evaluate the patient's risk of death. Overall, 26 patients died during the 8-years of the study. Results The metabolomic fingerprint at enrollment was powerful in discriminating patients who died (HR 5.71, p = 0.00002), even when adjusted for potential covariates. The outcome prediction of metabolomics surpassed that of N-terminal pro b-type natriuretic peptide (NT-proBNP) (HR 2.97, p = 0.005). Metabolomic fingerprinting was able to sub-stratify the risk of death in patients with both preserved/mid-range and reduced ejection fraction [hazard ratio (HR) 3.46, p = 0.03; HR 6.01, p = 0.004, respectively]. Metabolomics and left ventricular ejection fraction (LVEF), combined in a score, proved to be synergistic in predicting survival (HR 8.09, p = 0.0000004). Conclusions Metabolomic analysis via NMR enables fast and reproducible characterization of the serum metabolic fingerprint associated with poor prognosis in the HF setting. Our data suggest the importance of integrating several risk parameters to early identify HF patients at high-risk of poor outcomes.
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Affiliation(s)
- Alessia Vignoli
- Department of Chemistry “Ugo Schiff”, Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
- Interuniversity Consortium for Magnetic Resonance of Metalloproteins, Sesto Fiorentino, Italy
| | | | - Leonardo Tenori
- Department of Chemistry “Ugo Schiff”, Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
- Interuniversity Consortium for Magnetic Resonance of Metalloproteins, Sesto Fiorentino, Italy
| | | | - Elisabetta Cecconi
- Division of Cardiovascular and Perioperative Medicine, Careggi University Hospital, Florence, Italy
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Niccolò Marchionni
- Division of General Cardiology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Brunetto Alterini
- Division of Cardiovascular and Perioperative Medicine, Careggi University Hospital, Florence, Italy
- *Correspondence: Brunetto Alterini
| | - Claudio Luchinat
- Department of Chemistry “Ugo Schiff”, Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
- Interuniversity Consortium for Magnetic Resonance of Metalloproteins, Sesto Fiorentino, Italy
- Claudio Luchinat
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5
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Xu H, Wang Q, Liu Y, Meng L, Long H, Wang L, Liu D. U-Shaped Association Between Serum Uric Acid Level and Hypertensive Heart Failure: A Genetic Matching Case-Control Study. Front Cardiovasc Med 2021; 8:708581. [PMID: 34957229 PMCID: PMC8692761 DOI: 10.3389/fcvm.2021.708581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/17/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Heart failure (HF) is a global pandemic and lays an added burden on public healthcare. Previous studies indicated that high and low serum uric acid levels are associated with worse outcomes in many diseases. Reduced serum uric acid may not result in a better outcome. Methods: A comparative, matched cross-sectional study design was implemented. The matching variables were age, sex, BMI, BP, and histories of CKD, CVD, diabetes mellitus, stroke, hyperlipidemia. We reviewed the electronic medical records to identify patients diagnosed with hypertension or hypertensive heart failure (HHF) admitted to Beijing Hospital's cardiology department. Results: The median age of the two groups after matching are 71. There are 55.6% males in the hypertension group and 53.8% in the heart failure group. Univariate logistic regression analysis showed that UA's quadratic term is significant (OR = 1.00, 95% CI 1.00 to 1.00; P = 0.03), which indicated a u-shaped relationship between hypertension and HHF. FBS (OR = 0.22, 95% CI 0.05 to 0.95, p = 0.07) and HDL (OR = 1.23, 95% CI 1.00 to 1.54, P = 0.05) were not significant but close. Conclusion: Our results supported that both low and high uric acid levels were predictive of hypertensive heart failure. Besides, high-density lipoprotein cholesterol and fasting blood sugar were also associated with hypertensive heart failure. Low-density lipoprotein cholesterol was not associated with hypertensive heart failure.
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Affiliation(s)
- Hongxuan Xu
- Chinese Academy of Medical Sciences, National Center of Gerontology, National Health Commission, Department of Cardiology, Beijing Hospital, Institute of Geriatric Medicine, Beijing, China.,The Key Laboratory of Geriatrics, Chinese Academy of Medical Sciences, Beijing Institute of Geriatrics, Beijing Hospital National Center of Gerontology, Institute of Geriatric Medicine, Beijing, China
| | - Quan Wang
- Yuetan Community Health Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Yunqing Liu
- Chinese Academy of Medical Sciences, National Center of Gerontology, National Health Commission, Department of Cardiology, Beijing Hospital, Institute of Geriatric Medicine, Beijing, China.,The Key Laboratory of Geriatrics, Chinese Academy of Medical Sciences, Beijing Institute of Geriatrics, Beijing Hospital National Center of Gerontology, Institute of Geriatric Medicine, Beijing, China
| | - Lingbing Meng
- Chinese Academy of Medical Sciences, National Center of Gerontology, National Health Commission, Department of Cardiology, Beijing Hospital, Institute of Geriatric Medicine, Beijing, China.,Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China
| | - Huanyu Long
- The Key Laboratory of Geriatrics, Chinese Academy of Medical Sciences, Beijing Institute of Geriatrics, Beijing Hospital National Center of Gerontology, Institute of Geriatric Medicine, Beijing, China
| | - Li Wang
- The Key Laboratory of Geriatrics, Chinese Academy of Medical Sciences, Beijing Institute of Geriatrics, Beijing Hospital National Center of Gerontology, Institute of Geriatric Medicine, Beijing, China.,Chinese Academy of Medical Sciences, Departments of Neurology, National Center of Gerontology, Beijing Hospital, Institute of Geriatric Medicine, Beijing, China
| | - Deping Liu
- Chinese Academy of Medical Sciences, National Center of Gerontology, National Health Commission, Department of Cardiology, Beijing Hospital, Institute of Geriatric Medicine, Beijing, China.,Yuetan Community Health Center, Fuxing Hospital, Capital Medical University, Beijing, China.,Peking University Health Science Centre, Peking University Fifth School of Clinical Medicine, Beijing, China
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6
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Emmens JE, Jia C, Ng LL, van Veldhuisen DJ, Dickstein K, Anker SD, Lang CC, Filippatos G, Cleland JGF, Metra M, Voors AA, de Boer RA, Tietge UJF. Impaired High-Density Lipoprotein Function in Patients With Heart Failure. J Am Heart Assoc 2021; 10:e019123. [PMID: 33870728 PMCID: PMC8200730 DOI: 10.1161/jaha.120.019123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background We recently showed that, in patients with heart failure, lower high‐density lipoprotein (HDL) cholesterol concentration was a strong predictor of death or hospitalization for heart failure. In a follow‐up study, we suggested that this association could be partly explained by HDL proteome composition. However, whether the emerging concept of HDL function contributes to the prognosis of patients with heart failure has not been addressed. Methods and Results We measured 3 key protective HDL function metrics, namely, cholesterol efflux, antioxidative capacity, and anti‐inflammatory capacity, at baseline and after 9 months in 446 randomly selected patients with heart failure from BIOSTAT‐CHF (A Systems Biology Study to Tailored Treatment in Chronic Heart Failure). Additionally, the relationship between HDL functionality and HDL proteome composition was determined in 86 patients with heart failure. From baseline to 9 months, HDL cholesterol concentrations were unchanged, but HDL cholesterol efflux and anti‐inflammatory capacity declined (both P<0.001). In contrast, antioxidative capacity increased (P<0.001). Higher HDL cholesterol efflux was associated with lower mortality after adjusting for BIOSTAT‐CHF risk models and log HDL cholesterol (hazard ratio, 0.81; 95% CI, 0.71–0.92; P=0.001). Other functionality measures were not associated with outcome. Several HDL proteins correlated with HDL functionality, mainly with cholesterol efflux. Apolipoprotein A1 emerged as the main protein associated with all 3 HDL functionality measures. Conclusions Better HDL cholesterol efflux at baseline was associated with lower mortality during follow‐up, independent of HDL cholesterol. HDL cholesterol efflux and anti‐inflammatory capacity declined during follow‐up in patients with heart failure. Measures of HDL function may provide clinical information in addition to HDL cholesterol concentration in patients with heart failure.
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Affiliation(s)
- Johanna E Emmens
- Department of Cardiology University of Groningen Groningen The Netherlands
| | - Congzhuo Jia
- Department of Pediatrics University of Groningen Groningen The Netherlands.,Division of Clinical Chemistry Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden
| | - Leong L Ng
- Department of Cardiovascular Sciences Glenfield HospitalUniversity of Leicester Leicester UK.,NIHR Leicester Biomedical Research Centre Leicester UK
| | | | - Kenneth Dickstein
- University of Bergen Bergen Norway.,Stavanger University Hospital Stavanger Norway
| | - Stefan D Anker
- Department of Cardiology (CVK) Berlin Germany.,Berlin-Brandenburg Center for Regenerative Therapies (BCRT) Berlin Germany.,German Centre for Cardiovascular Research (DZHK) partner site Berlin Charité Universitätsmedizin Berlin Berlin Germany.,Department of Cardiology and Pneumology University Medical Center Göttingen (UMG) Göttingen Germany
| | - Chim C Lang
- School of Medicine Centre for Cardiovascular and Lung Biology Division of Molecular and Clinical Medicine University of Dundee Dundee UK
| | - Gerasimos Filippatos
- National and Kapodistrian University of AthensSchool of Medicine Athens Greece.,University of CyprusSchool of Medicine Nicosia Cyprus
| | - John G F Cleland
- National Heart & Lung InstituteRoyal Brompton & Harefield HospitalsImperial College London UK.,Robertson Institute of Biostatistics and Clinical Trials Unit University of Glasgow Glasgow UK
| | - Marco Metra
- Institute of Cardiology Department of Medical and Surgical Specialties Radiological Sciences and Public Health University of Brescia Brescia Italy
| | - Adriaan A Voors
- Department of Cardiology University of Groningen Groningen The Netherlands
| | - Rudolf A de Boer
- Department of Cardiology University of Groningen Groningen The Netherlands
| | - Uwe J F Tietge
- Department of Pediatrics University of Groningen Groningen The Netherlands.,Division of Clinical Chemistry Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden.,Clinical Chemistry Karolinska University LaboratoryKarolinska University Hospital Stockholm SE-141 86 Sweden
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7
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High-Density Lipoprotein-Targeted Therapies for Heart Failure. Biomedicines 2020; 8:biomedicines8120620. [PMID: 33339429 PMCID: PMC7767106 DOI: 10.3390/biomedicines8120620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 02/08/2023] Open
Abstract
The main and common constituents of high-density lipoproteins (HDLs) are apolipoprotein A-I, cholesterol, and phospholipids. Biochemical heterogeneity of HDL particles is based on the variable presence of one or more representatives of at least 180 proteins, 200 lipid species, and 20 micro RNAs. HDLs are circulating multimolecular platforms that perform divergent functions whereby the potential of HDL-targeted interventions for treatment of heart failure can be postulated based on its pleiotropic effects. Several murine studies have shown that HDLs exert effects on the myocardium, which are completely independent of any impact on coronary arteries. Overall, HDL-targeted therapies exert a direct positive lusitropic effect on the myocardium, inhibit the development of cardiac hypertrophy, suppress interstitial and perivascular myocardial fibrosis, increase capillary density in the myocardium, and prevent the occurrence of heart failure. In four distinct murine models, HDL-targeted interventions were shown to be a successful treatment for both pre-existing heart failure with reduced ejection fraction (HFrEF) and pre-existing heart failure with preserved ejection fraction (HFrEF). Until now, the effect of HDL-targeted interventions has not been evaluated in randomized clinical trials in heart failure patients. As HFpEF represents an important unmet therapeutic need, this is likely the preferred therapeutic domain for clinical translation.
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8
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Mishra M, Muthuramu I, De Geest B. HDL dysfunction, function, and heart failure. Aging (Albany NY) 2020; 11:293-294. [PMID: 30654330 PMCID: PMC6366992 DOI: 10.18632/aging.101775] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 01/15/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Mudit Mishra
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Ilayaraja Muthuramu
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Bart De Geest
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
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9
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High-Density Lipoprotein Particle Subfractions in Heart Failure With Preserved or Reduced Ejection Fraction. J Am Coll Cardiol 2019; 73:177-186. [PMID: 30654890 DOI: 10.1016/j.jacc.2018.10.059] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/07/2018] [Accepted: 10/10/2018] [Indexed: 12/15/2022]
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.
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10
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Lee MMY, Sattar N, McMurray JJV, Packard CJ. Statins in the Prevention and Treatment of Heart Failure: a Review of the Evidence. Curr Atheroscler Rep 2019; 21:41. [PMID: 31350612 PMCID: PMC6660504 DOI: 10.1007/s11883-019-0800-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Purpose of Review We summarize the best evidence for statins in the prevention and treatment of heart failure. Recent Findings In patients with cardiovascular risk factors or established atherosclerotic cardiovascular disease (but without heart failure), statins reduce the risk of incident heart failure—mainly by preventing myocardial infarction although an additional benefit from reducing myocardial ischemia cannot be excluded. However, in patients with established heart failure, statins do not reduce the risk of cardiovascular death, which is mainly caused by pump failure and ventricular arrhythmias. Retrospective analyses, however, suggest that statins may reduce the rate of heart failure hospitalization and atherosclerotic events (which are proportionately much less common in these patients than heart failure hospitalization or death). Summary Statin therapy should probably be continued in patients with coronary artery disease developing heart failure, although the weak evidence and small benefit may not justify the use of this treatment in very elderly patients with a short life expectancy and in which polypharmacy is a problem.
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Affiliation(s)
- Matthew M Y Lee
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland.
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland
| | - John J V McMurray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland
| | - Chris J Packard
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland
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11
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Zeng N, Wang A, Xu T, Zhong C, Zheng X, Zhu Z, Peng Y, Peng H, Li Q, Ju Z, Geng D, Zhang Y, He J. Co-Effect of Serum Galectin-3 and High-Density Lipoprotein Cholesterol on the Prognosis of Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2019; 28:1879-1885. [DOI: 10.1016/j.jstrokecerebrovasdis.2019.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 03/27/2019] [Accepted: 04/06/2019] [Indexed: 01/05/2023] Open
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12
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Radulović B, Potočnjak I, Dokoza Terešak S, Trbušić M, Vrkić N, Huršidić Radulović A, Starčević N, Milošević M, Degoricija V, Frank S. CHOLESTEROL AND CHLORIDE IN ACUTE HEART FAILURE. Acta Clin Croat 2019; 58:195-201. [PMID: 31819314 PMCID: PMC6884370 DOI: 10.20471/acc.2019.58.02.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 12/20/2018] [Indexed: 01/10/2023] Open
Abstract
Detecting predictors of poor outcome is crucial for understanding the underlying pathophysiology of heart failure (HF) and thus creating new therapeutic concepts. It is well established that low serum lipid levels are associated with unfavorable outcomes in HF patients. Several studies examined the association between serum lipids and established predictors of mortality in HF patients. The aim of the present study was to examine the association of serum lipid and chloride concentrations, as well as their impact on survival in acute heart failure (AHF). The present study was performed as a prospective, single-centre, observational research. The study included 152 patients with AHF. Spearman's correlation coefficient revealed a significant positive correlation of serum chloride levels with serum levels of total cholesterol (ρ 0.221, p=0.006), low-density lipoprotein cholesterol (LDL-c) (ρ 0.187, p=0.015) and high-density lipoprotein-cholesterol (HDL-c) (ρ 0.169, p=0.038). Binary logistic regression revealed a significant association of chloride, total cholesterol and LDL-c serum levels measured at admission with hospital survival (OR 1.077, CI 1.01-1.154, p=0.034), (OR 1.731, CI 1.090-2.748, p=0.020) and (OR 1.839, CI 1.033-3.274, p=0.038), respectively, as well as with 3-month survival (OR 1.065, CI 1.002-1.131, p=0.042), (OR 1.625, CI 1.147-2.303, p=0.006) and (OR 1.711, CI 1.117-2.622, p=0.014), respectively. In conclusion, positive statistical association between serum cholesterol (total cholesterol, LDL-c and HDL-c) and chloride levels may suggest their similar modulation by AHF pathophysiology. Serum levels of total cholesterol, LDL-c and chloride contribute to patient survival.
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13
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Ventura HO, Lavie CJ, Mehra MR. HDL and Heart Failure Regulation. J Am Coll Cardiol 2019; 73:187-189. [DOI: 10.1016/j.jacc.2018.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022]
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HDL subclasses and mortality in acute heart failure patients. Clin Chim Acta 2018; 490:81-87. [PMID: 30578754 PMCID: PMC6591134 DOI: 10.1016/j.cca.2018.12.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/14/2018] [Accepted: 12/18/2018] [Indexed: 12/30/2022]
Abstract
The link between HDL subclasses and the prognosis of cardiovascular diseases remains controversial. We thus evaluated the prognostic value of the HDL subclasses 3 and 2 cholesterol (HDL3-C, HDL2-C) as well as of total HDL-C for 3-month mortality in acute heart failure (AHF) patients. The serum levels of HDL3-C and total HDL-C were determined by detergent-based homogeneous assay. HDL2-C was computed by the difference between total HDL-C and HDL3-C. Out of the 132 analyzed patients, 35 (26.5%) died within three months after onset of AHF. Univariate logistic regression analyses revealed a significant inverse association of HDL3-C (odds ratio (OR) 0.46 per 1-SD increase, 95% confidence interval (CI) 0.27–0.72, p = 0.001) with 3-month mortality, whereas concentrations of total HDL-C and HDL2-C showed no significant association. After adjustment for various laboratory and clinical parameters known to be associated with mortality in heart failure patients, HDL3-C concentrations remained significantly associated with 3-month mortality (OR 0.34 per 1-SD increase, 95% CI 0.15–0.74, p =0.010). We conclude that low admission serum levels of HDL3-C are associated with an increased 3-month mortality in AHF patients, whereas total HDL-C and HDL2-C showed no association. HDL3-C might thus be useful as a prognostic parameter in AHF.
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15
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Aboumsallem JP, Mishra M, Amin R, Muthuramu I, Kempen H, De Geest B. Successful treatment of established heart failure in mice with recombinant HDL (Milano). Br J Pharmacol 2018; 175:4167-4182. [PMID: 30079544 PMCID: PMC6177616 DOI: 10.1111/bph.14463] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE The pleiotropic properties of HDL may exert beneficial effects on the myocardium. The effect of recombinant HDLMilano on established heart failure was evaluated in C57BL/6 mice. EXPERIMENTAL APPROACH Mice were subjected to transverse aortic constriction (TAC) or sham operation at the age of 14 weeks. Eight weeks later, TAC and sham mice were each randomized into three different groups. Reference groups were killed at day 56 after the operation for baseline analysis. Five i.p. injections of recombinant HDLMilano (MDCO-216), 100 mg·kg-1 , or an equivalent volume of control buffer were administered with a 48 h interval starting at day 56. Endpoint analyses in the control buffer groups and in the MDCO-216 groups were executed at day 65. KEY RESULTS Lung weight in MDCO-216 TAC mice was 25.3% lower than in reference TAC mice and 27.9% lower than in control buffer TAC mice and was similar in MDCO-216 sham mice. MDCO-216 significantly decreased interstitial fibrosis and increased relative vascularity compared to reference TAC mice and control buffer TAC mice. The peak rate of isovolumetric relaxation in MDCO-216 TAC mice was 30.4 and 36.3% higher than in reference TAC mice and control buffer TAC mice respectively. Nitro-oxidative stress and myocardial apoptosis were significantly reduced in MDCO-216 TAC mice compared to control buffer TAC mice. CONCLUSIONS AND IMPLICATIONS MDCO-216 improves diastolic function, induces regression of interstitial fibrosis and normalizes lung weight in mice with established heart failure. Recombinant HDL may emerge as a treatment modality in heart failure.
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Affiliation(s)
- Joseph Pierre Aboumsallem
- Centre for Molecular and Vascular Biology, Department of Cardiovascular SciencesCatholic University of LeuvenLeuvenBelgium
| | - Mudit Mishra
- Centre for Molecular and Vascular Biology, Department of Cardiovascular SciencesCatholic University of LeuvenLeuvenBelgium
| | - Ruhul Amin
- Centre for Molecular and Vascular Biology, Department of Cardiovascular SciencesCatholic University of LeuvenLeuvenBelgium
| | - Ilayaraja Muthuramu
- Centre for Molecular and Vascular Biology, Department of Cardiovascular SciencesCatholic University of LeuvenLeuvenBelgium
| | - Herman Kempen
- The Medicines Company (Schweiz) GmbHZürichSwitzerland
| | - Bart De Geest
- Centre for Molecular and Vascular Biology, Department of Cardiovascular SciencesCatholic University of LeuvenLeuvenBelgium
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Martinelli AEM, Maranhão RC, Carvalho PO, Freitas FR, Silva BMO, Curiati MNC, Kalil Filho R, Pereira-Barretto AC. Cholesteryl ester transfer protein (CETP), HDL capacity of receiving cholesterol and status of inflammatory cytokines in patients with severe heart failure. Lipids Health Dis 2018; 17:242. [PMID: 30342531 PMCID: PMC6195750 DOI: 10.1186/s12944-018-0888-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/03/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Heart failure (HF) courses with chronic inflammatory process and alterations in lipid metabolism may aggravate the disease. The aim was to test whether the severity of HF, using brain natriuretic peptide (BNP) as a marker, is associated with alterations in functional aspects of HDL, such as lipid transfer, cholesterol ester transfer protein (CETP) and lecithin-cholesterol acyltransferase (LCAT) concentration. METHODS Twenty-five HF patients in NYHA class I/II and 23 in class III/IV were enrolled. Plasma lipids, apolipoproteins, CETP, LCAT, oxidized-LDL (oxLDL) and paraoxonase-1 (PON-1) activity were determined. Lipid transfer from a donor artificial nanoparticle to HDL was measured by in vitro assay. RESULTS Total cholesterol (p = 0.049), LDL-C (p = 0.023), non-HDL-C (p = 0.029) and CETP, that promotes lipid transfer among lipoproteins (p = 0.013), were lower in III/IV than in I/II group. Triglycerides, HDL-C, apo A-I, apo B, oxLDL, LCAT, enzyme that catalyzes serum cholesterol esterification, PON-1 activity, and in vitro transfers of cholesterol, triglycerides and phospholipids to HDL, important steps in HDL metabolism, were equal. IL-8 was higher in III/IV (p = 0.025), but TNFα, IL-1β, IL-6 and MCP-1 were equal. BNP was negatively correlated with CETP (r = - 0.294; p = 0.042) and positively correlated with IL-8 (r = 0.299; p = 0.039). CONCLUSIONS Our results disclosed the relationship between CETP levels and HF severity, by comparing two HF groups and by correlation analysis. Lower CETP levels may be a marker of HF aggravation and possibly of worse prognosis. Practical applications of this initial finding, as the issue whether CETP could be protective against HF aggravation, should be explored in larger experimental and clinical studies.
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Affiliation(s)
- Ana Elisa M Martinelli
- Laboratorio de Metabolismo e Lipides, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. 1° subsolo, São Paulo, SP, 05403-000, Brazil
| | - Raul C Maranhão
- Laboratorio de Metabolismo e Lipides, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. 1° subsolo, São Paulo, SP, 05403-000, Brazil. .,Faculdade de Ciencias Farmaceuticas, Universidade de Sao Paulo, São Paulo, Brazil.
| | - Priscila O Carvalho
- Laboratorio de Metabolismo e Lipides, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. 1° subsolo, São Paulo, SP, 05403-000, Brazil
| | - Fatima R Freitas
- Laboratorio de Metabolismo e Lipides, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. 1° subsolo, São Paulo, SP, 05403-000, Brazil
| | - Bruna M O Silva
- Laboratorio de Metabolismo e Lipides, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. 1° subsolo, São Paulo, SP, 05403-000, Brazil
| | - Milena N C Curiati
- Hospital Santa Marcelina, São Paulo, Brazil.,Servico de Prevencao e Reabilitacao Cardiovascular, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Roberto Kalil Filho
- Laboratorio de Metabolismo e Lipides, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Enéas de Carvalho Aguiar, 44. 1° subsolo, São Paulo, SP, 05403-000, Brazil
| | - Antonio Carlos Pereira-Barretto
- Servico de Prevencao e Reabilitacao Cardiovascular, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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17
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Emmens JE, Jones DJL, Cao TH, Chan DCS, Romaine SPR, Quinn PA, Anker SD, Cleland JG, Dickstein K, Filippatos G, Hillege HL, Lang CC, Ponikowski P, Samani NJ, van Veldhuisen DJ, Zannad F, Zwinderman AH, Metra M, de Boer RA, Voors AA, Ng LL. Proteomic diversity of high-density lipoprotein explains its association with clinical outcome in patients with heart failure. Eur J Heart Fail 2017; 20:260-267. [PMID: 29251807 DOI: 10.1002/ejhf.1101] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/26/2017] [Accepted: 11/09/2017] [Indexed: 11/10/2022] Open
Abstract
AIMS Previously, low high-density lipoprotein (HDL) cholesterol was found to be one of the strongest predictors of mortality and/or heart failure (HF) hospitalisation in patients with HF. We therefore performed in-depth investigation of the multifunctional HDL proteome to reveal underlying pathophysiological mechanisms explaining the association between HDL and clinical outcome. METHODS AND RESULTS We selected a cohort of 90 HF patients with 1:1 cardiovascular death/survivor ratio from BIOSTAT-CHF. A novel optimised protocol for selective enrichment of lipoproteins was used to prepare plasma. Enriched lipoprotein content of samples was analysed using high resolution nanoscale liquid chromatography-mass spectrometry-based proteomics, utilising a label free approach. Within the HDL proteome, 49 proteins significantly differed between deaths and survivors. An optimised model of 12 proteins predicted death with 76% accuracy (Nagelkerke R2 =0.37, P < 0.001). The strongest contributors to this model were filamin-A (related to crosslinking of actin filaments) [odds ratio (OR) 0.31, 95% confidence interval (CI) 0.15-0.61, P = 0.001] and pulmonary surfactant-associated protein B (related to alveolar capillary membrane function) (OR 2.50, 95% CI 1.57-3.98, P < 0.001). The model predicted mortality with an area under the curve of 0.82 (95% CI 0.77-0.87, P < 0.001). Internal cross validation resulted in 73.3 ± 7.2% accuracy. CONCLUSION This study shows marked differences in composition of the HDL proteome between HF survivors and deaths. The strongest differences were seen in proteins reflecting crosslinking of actin filaments and alveolar capillary membrane function, posing potential pathophysiological mechanisms underlying the association between HDL and clinical outcome in HF.
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Affiliation(s)
- Johanna Elisabeth Emmens
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Donald J L Jones
- Department of Cancer Studies, University of Leicester, Leicester Royal Infirmary, Leicester, UK
| | - Thong H Cao
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK.,Department of General Internal Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Daniel C S Chan
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Simon P R Romaine
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Paulene A Quinn
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Stefan D Anker
- Division of Cardiology and Metabolism - Heart Failure, Cachexia and Sarcopenia, Department of Cardiology (CVK); and Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) Berlin, Charité Universitätsmedizin Berlin, Germany.,Department of Cardiology and Pneumology, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - John G Cleland
- National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London, UK
| | - Kenneth Dickstein
- University of Bergen, Bergen, Norway.,Stavanger University Hospital, Stavanger, Norway
| | - Gerasimos Filippatos
- National and Kapodistrian University of Athens, School of Medicine, Heart Failure Unit, Department of Cardiology, Athens University Hospital Attikon, Athens, Greece
| | - Hans L Hillege
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Chim C Lang
- School of Medicine Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK
| | - Piotr Ponikowski
- Department of Heart Diseases, Wroclaw Medical University, and Cardiology Department, Military Hospital, Wroclaw, Poland
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Dirk J van Veldhuisen
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Faiz Zannad
- Inserm CIC 1433, Université de Lorrain, CHU de Nancy, Nancy, France
| | - Aeilko H Zwinderman
- Department of Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands
| | - Marco Metra
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Rudolf A de Boer
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Adriaan A Voors
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Leong L Ng
- Department of Cardiovascular Sciences, University of Leicester, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
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18
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Vest AR, Kennel PJ, Maldonado D, Young JB, Mountis MM, Naka Y, Colombo PC, Mancini DM, Starling RC, Schulze PC. Recovery of Serum Cholesterol Predicts Survival After Left Ventricular Assist Device Implantation. Circ Heart Fail 2017; 9:CIRCHEARTFAILURE.115.002881. [PMID: 27623768 DOI: 10.1161/circheartfailure.115.002881] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 08/10/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Advanced systolic heart failure is associated with myocardial and systemic metabolic abnormalities, including low levels of total cholesterol and low-density lipoprotein. Low cholesterol and low-density lipoprotein have been associated with greater mortality in heart failure. Implantation of a left ventricular assist device (LVAD) reverses some of the metabolic derangements of advanced heart failure. METHODS AND RESULTS A cohort was retrospectively assembled from 2 high-volume implantation centers, totaling 295 continuous-flow LVAD recipients with ≥2 cholesterol values available. The cohort was predominantly bridge-to-transplantation (67%), with median age of 59 years and 49% ischemic heart failure cause. Total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglyceride levels all significantly increased after LVAD implantation (median values from implantation to 3 months post implantation 125-150 mg/dL, 67-85 mg/dL, 32-42 mg/dL, and 97-126 mg/dL, respectively). On Cox proportional hazards modeling, patients achieving recovery of total cholesterol levels, defined as a median or greater change from pre implantation to 3 months post-LVAD implantation, had significantly better unadjusted survival (hazard ratio, 0.445; 95% confidence interval, 0.212-0.932) and adjusted survival (hazard ratio, 0.241; 95% confidence interval, 0.092-0.628) than those without cholesterol recovery after LVAD implantation. The continuous variable of total cholesterol at 3 months post implantation and the cholesterol increase from pre implantation to 3 months were also both significantly associated with survival during LVAD support. CONCLUSIONS Initiation of continuous-flow LVAD support was associated with significant recovery of all 4 lipid variables. Patients with a greater increase in total cholesterol by 3 months post implantation had superior survival during LVAD support.
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Affiliation(s)
- Amanda R Vest
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.).
| | - Peter J Kennel
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - Dawn Maldonado
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - James B Young
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - Maria M Mountis
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - Yoshifumi Naka
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - Paolo C Colombo
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - Donna M Mancini
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - Randall C Starling
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
| | - P Christian Schulze
- From the Division of Cardiology, Department of Medicine, Tufts Medical Center, Boston, MA (A.R.V.); Division of Cardiology, Department of Medicine (P.J.K., D.M., P.C.C., P.C.S.) and Division of Cardiothoracic Surgery, Department of Surgery (Y.N.), Columbia University Medical Center, New York; Kaufman Center for Heart Failure, Cardiovascular Medicine Department, Heart and Vascular Institute, Cleveland Clinic, OH (J.B.Y., M.M.M., R.C.S.); Division of Cardiology, Department of Medicine, Mount Sinai Icahn School of Medicine, New York (D.M.M.); and Department of Internal Medicine I, Division of Cardiology, Angiology, Pneumology and Intensive Medical Care, University Hospital Jena, Friedrich-Schiller-University Jena, Germany (P.C.S.)
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19
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Treece J, Chemchirian H, Hamilton N, Jbara M, Gangadharan V, Paul T, Baumrucker SJ. A Review of Prognostic Tools in Heart Failure. Am J Hosp Palliat Care 2017; 35:514-522. [PMID: 28554221 DOI: 10.1177/1049909117709468] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A minority of patients with end-stage disease are referred to palliative medicine for consultation in advanced heart failure. Educating stakeholders, including primary care, cardiology, and critical care of the benefits of hospice and palliative medicine for patients with poor prognosis, may increase appropriately timed referrals and improve quality of life for these patients. This article reviews multiple tools useful in prognostication in the setting of advanced heart failure.
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Affiliation(s)
- Jennifer Treece
- 1 Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Hrak Chemchirian
- 2 Department of Cardiology, Charleston Area Medical Center, Charleston, WV, USA
| | - Neil Hamilton
- 1 Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Manar Jbara
- 3 Department of Cardiology, ETSU College of Medicine, Johnson City, TN, USA
| | | | - Timir Paul
- 3 Department of Cardiology, ETSU College of Medicine, Johnson City, TN, USA
| | - Steven J Baumrucker
- 5 Department of Hospice and Palliative Medicine, Wellmont Health System, Kingsport, TN, USA
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Serum Concentration of HDL Particles Predicts Mortality in Acute Heart Failure Patients. Sci Rep 2017; 7:46642. [PMID: 28418031 PMCID: PMC5394530 DOI: 10.1038/srep46642] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 03/21/2017] [Indexed: 12/31/2022] Open
Abstract
Clinical studies have shown that assessing circulating concentrations of high-density lipoprotein (HDL) particles by nuclear magnetic resonance (NMR) spectroscopy is superior to HDL-cholesterol in predicting cardiovascular risk. We tested the hypothesis that circulating concentrations of HDL particles predict 3-month mortality of patients with acute heart failure (AHF). Out of 152 included patients, 52% were female, additionally the mean patient age was 75.2 ± 10.3 years, and three-month mortality was 27%. Serum lipoprotein profile at admission was determined by NMR spectroscopy. Univariate logistic regression analyses revealed a significant inverse association of total (odds ratio (OR) 0.38 per 1-SD increase, 95% confidence interval (CI) 0.23-0.60, p < 0.001) and small HDL particle concentrations (OR 0.35 per 1-SD increase, 95% CI 0.19-0.60, p < 0.001) with 3-month mortality, whereas concentrations of large HDL particles (p = 0.353) or HDL-cholesterol (p = 0.107) showed no significant association. After adjustment for age, sex, mean arterial pressure, low-density lipoprotein cholesterol, glomerular filtration rate, urea, and N-terminal pro-brain natriuretic peptide, both the total and small HDL particle concentrations remained significantly associated with 3-month mortality. Based on our results, we conclude that total and small HDL particle concentrations strongly and independently predict 3-month mortality in AHF patients.
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Voors AA, Ouwerkerk W, Zannad F, van Veldhuisen DJ, Samani NJ, Ponikowski P, Ng LL, Metra M, ter Maaten JM, Lang CC, Hillege HL, van der Harst P, Filippatos G, Dickstein K, Cleland JG, Anker SD, Zwinderman AH. Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure. Eur J Heart Fail 2017; 19:627-634. [DOI: 10.1002/ejhf.785] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 11/29/2016] [Accepted: 12/05/2016] [Indexed: 12/28/2022] Open
Affiliation(s)
- Adriaan A. Voors
- Department of Cardiology, University of Groningen; University Medical Centre Groningen; Hanzeplein 1 9713 GZ Groningen the Netherlands
| | - Wouter Ouwerkerk
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
| | - Faiez Zannad
- Inserm CIC 1433; Université de Lorrain, CHU de Nancy; Nancy France
| | - Dirk J. van Veldhuisen
- Department of Cardiology, University of Groningen; University Medical Centre Groningen; Hanzeplein 1 9713 GZ Groningen the Netherlands
| | - Nilesh J. Samani
- Department of Cardiovascular Sciences; University of Leicester, Glenfield Hospital, Leicester, UK and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; Leicester UK
| | - Piotr Ponikowski
- Department of Heart Diseases, Wroclaw Medical University, Poland and Cardiology Department; Military Hospital; Wroclaw Poland
| | - Leong L. Ng
- Department of Cardiovascular Sciences; University of Leicester, Glenfield Hospital, Leicester, UK and NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; Leicester UK
| | - Marco Metra
- Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health; University of Brescia; Italy
| | - Jozine M. ter Maaten
- Department of Cardiology, University of Groningen; University Medical Centre Groningen; Hanzeplein 1 9713 GZ Groningen the Netherlands
| | - Chim C. Lang
- School of Medicine Centre for Cardiovascular and Lung Biology, Division of Medical Sciences; University of Dundee, Ninewells Hospital and Medical School; Dundee UK
| | - Hans L. Hillege
- Department of Cardiology, University of Groningen; University Medical Centre Groningen; Hanzeplein 1 9713 GZ Groningen the Netherlands
| | - Pim van der Harst
- Department of Cardiology, University of Groningen; University Medical Centre Groningen; Hanzeplein 1 9713 GZ Groningen the Netherlands
| | - Gerasimos Filippatos
- Department of Cardiology, Heart Failure Unit; Athens University Hospital Attikon, National and Kapodistrian University of Athens; Athens Greece
| | - Kenneth Dickstein
- University of Stavanger; Stavanger Norway
- University of Bergen; Bergen Norway
| | - John G. Cleland
- National Heart and Lung Institute; Royal Brompton and Harefield Hospitals, Imperial College; London UK
| | - Stefan D. Anker
- Innovative Clinical Trials, Department of Cardiology and Pneumology; University Medical Centre Göttingen (UMG); Göttingen Germany
| | - Aeilko H. Zwinderman
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Centre; University of Amsterdam; Amsterdam the Netherlands
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Potočnjak I, Degoricija V, Trbušić M, Terešak SD, Radulović B, Pregartner G, Berghold A, Tiran B, Marsche G, Frank S. Metrics of High-Density Lipoprotein Function and Hospital Mortality in Acute Heart Failure Patients. PLoS One 2016; 11:e0157507. [PMID: 27304214 PMCID: PMC4909230 DOI: 10.1371/journal.pone.0157507] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 05/30/2016] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The functionality of high-density lipoprotein (HDL) is impaired in chronic ischaemic heart failure (HF). However, the relationship between HDL functionality and outcomes in acute HF (AHF) has not been studied. The present study investigates whether the metrics of HDL functionality, including HDL cholesterol efflux capacity and HDL-associated paraoxonase (PON)-1 arylesterase (AE) activity are associated with hospital mortality in AHF patients. METHODS AND RESULTS The study was performed as a prospective, single-centre, observational research on 152 patients, defined and categorised according to the ESC and ACCF/AHA Guidelines for HF by time of onset, final clinical presentation and ejection fraction. The mean age of the included patients (52% female) was 75.2 years (SD 10.3) and hospital mortality was 14.5%. HDL cholesterol efflux capacity was examined by measuring the capacity of apoB depleted serum to remove tritium-labelled cholesterol from cultured macrophages. The AE activity of the HDL fraction was examined by a photometric assay. In a univariable regression analysis, low cholesterol efflux, but not AE activity, was significantly associated with hospital mortality [odds ratio (OR) 0.78, 95% confidence interval (CI) 0.64-0.96, p = 0.019]. In multivariable analysis progressively adjusting for important clinical and laboratory parameters the association obtained for cholesterol efflux capacity and hospital mortality by univariable analysis, despite a stable OR, did not stay significant (p = 0.179). CONCLUSION Our results suggest that HDL cholesterol efflux capacity (but not AE activity) contributes to, but is not an independent risk factor for, hospital mortality in AHF patients. Larger studies are needed to draw firm conclusions.
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Affiliation(s)
- Ines Potočnjak
- University Hospital Centre Sisters of Charity, Department of Medicine, Zagreb, Croatia
- * E-mail: (IP); (GM); (SF)
| | - Vesna Degoricija
- University Hospital Centre Sisters of Charity, Department of Medicine, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Matias Trbušić
- University Hospital Centre Sisters of Charity, Department of Medicine, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Sanda Dokoza Terešak
- University Hospital Centre Sisters of Charity, Department of Medicine, Zagreb, Croatia
| | | | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics und Documentation, Medical University of Graz, Graz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics und Documentation, Medical University of Graz, Graz, Austria
| | - Beate Tiran
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Gunther Marsche
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz, Austria
- * E-mail: (IP); (GM); (SF)
| | - Saša Frank
- Institute of Molecular Biology and Biochemistry, Centre of Molecular Medicine, Medical University Graz, Graz, Austria
- * E-mail: (IP); (GM); (SF)
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Lin L, Liu X, Xu J, Weng L, Ren J, Ge J, Zou Y. High-density lipoprotein inhibits mechanical stress-induced cardiomyocyte autophagy and cardiac hypertrophy through angiotensin II type 1 receptor-mediated PI3K/Akt pathway. J Cell Mol Med 2015; 19:1929-38. [PMID: 25946687 PMCID: PMC4549043 DOI: 10.1111/jcmm.12567] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 01/29/2015] [Indexed: 12/24/2022] Open
Abstract
Mechanical stress triggers cardiac hypertrophy and autophagy through an angiotensin II (Ang II) type 1 (AT1) receptor-dependent mechanism. Low level of high density lipoprotein (HDL) is an independent risk factor for cardiac hypertrophy. This study was designed to evaluate the effect of HDL on mechanical stress-induced cardiac hypertrophy and autophagy. A 48-hr mechanical stretch and a 4-week transverse aortic constriction were employed to induce cardiomyocyte hypertrophy in vitro and in vivo, respectively, prior to the assessment of myocardial autophagy using LC3b-II and beclin-1. Our results indicated that HDL significantly reduced mechanical stretch-induced rise in autophagy as demonstrated by LC3b-II and beclin-1. In addition, mechanical stress up-regulated AT1 receptor expression in both cultured cardiomyocytes and in mouse hearts, whereas HDL significantly suppressed the AT1 receptor. Furthermore, the role of Akt phosphorylation in HDL-mediated action was assessed using MK-2206, a selective inhibitor for Akt phosphorylation. Our data further revealed that MK-2206 mitigated HDL-induced beneficial responses on cardiac remodelling and autophagy. Taken together, our data revealed that HDL inhibited mechanical stress-induced cardiac hypertrophy and autophagy through downregulation of AT1 receptor, and HDL ameliorated cardiac hypertrophy and autophagy via Akt-dependent mechanism.
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Affiliation(s)
- Li Lin
- Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xuebo Liu
- Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianfeng Xu
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institute of Biomedical Science, Fudan University, Shanghai, China
| | - Liqing Weng
- Department of Cardiovascular Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jun Ren
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institute of Biomedical Science, Fudan University, Shanghai, China
| | - Junbo Ge
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institute of Biomedical Science, Fudan University, Shanghai, China
| | - Yunzeng Zou
- Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital and Institute of Biomedical Science, Fudan University, Shanghai, China
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Van Linthout S, Frias M, Singh N, De Geest B. Therapeutic potential of HDL in cardioprotection and tissue repair. Handb Exp Pharmacol 2015; 224:527-565. [PMID: 25523001 DOI: 10.1007/978-3-319-09665-0_17] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Epidemiological studies support a strong association between high-density lipoprotein (HDL) cholesterol levels and heart failure incidence. Experimental evidence from different angles supports the view that low HDL is unlikely an innocent bystander in the development of heart failure. HDL exerts direct cardioprotective effects, which are mediated via its interactions with the myocardium and more specifically with cardiomyocytes. HDL may improve cardiac function in several ways. Firstly, HDL may protect the heart against ischaemia/reperfusion injury resulting in a reduction of infarct size and thus in myocardial salvage. Secondly, HDL can improve cardiac function in the absence of ischaemic heart disease as illustrated by beneficial effects conferred by these lipoproteins in diabetic cardiomyopathy. Thirdly, HDL may improve cardiac function by reducing infarct expansion and by attenuating ventricular remodelling post-myocardial infarction. These different mechanisms are substantiated by in vitro, ex vivo, and in vivo intervention studies that applied treatment with native HDL, treatment with reconstituted HDL, or human apo A-I gene transfer. The effect of human apo A-I gene transfer on infarct expansion and ventricular remodelling post-myocardial infarction illustrates the beneficial effects of HDL on tissue repair. The role of HDL in tissue repair is further underpinned by the potent effects of these lipoproteins on endothelial progenitor cell number, function, and incorporation, which may in particular be relevant under conditions of high endothelial cell turnover. Furthermore, topical HDL therapy enhances cutaneous wound healing in different models. In conclusion, the development of HDL-targeted interventions in these strategically chosen therapeutic areas is supported by a strong clinical rationale and significant preclinical data.
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Affiliation(s)
- Sophie Van Linthout
- Charité-University-Medicine Berlin, Campus Virchow, Berlin-Brandenburg Center for Regenerative Therapy (BCRT), Berlin, Germany
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25
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Li XL, Li JJ, Guo YL, Zhu CG, Qing P, Wu NQ, Xu B, Gao RL. The ratio of high-density lipoprotein cholesterol to apolipoprotein A-I predicts myocardial injury following elective percutaneous coronary intervention. Clin Cardiol 2014; 37:558-65. [PMID: 25113039 DOI: 10.1002/clc.22308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 04/21/2014] [Accepted: 05/27/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND High-density lipoprotein (HDL) has cardioprotective properties. Each HDL particle has a few molecules of apolipoprotein A-I (apoA-I) and carries various amounts of cholesterol. The ratio of high-density lipoprotein cholesterol (HDL-C) to apoA-I may reflect mean HDL particle size. HYPOTHESIS HDL-C/apoA-I ratio may provide more information than HDL-C and apoA-I in predicting myocardial injury following elective percutaneous coronary intervention (PCI). METHODS We prospectively enrolled 2529 consecutive patients who underwent elective PCI and assessed the relationships of preprocedural HDL-C, apoA-I, and their ratio with peak cardiac troponin I (cTnI) within 24 hours after PCI. RESULTS Neither HDL-C nor apoA-I levels showed significant association with postprocedural cTnI elevation, whereas HDL-C/apoA-I ratio was associated with postprocedural cTnI elevation above 3 up to 30 × upper limit of normal (ULN), with the lowest risk in the middle quintile (all P values for quadratic term were <0.05). Adjusted odds ratios (95% confidence interval) of postprocedural cTnI >3 × ULN for quintile 1 to 5 of HDL-C/apoA-I ratio were: 1 (reference), 0.81 (0.62-1.07), 0.57 (0.43-0.75), 0.65 (0.49-0.85), and 0.76 (0.58-1.01), respectively, and the adjusted odds ratios of postprocedural cTnI >30 × ULN for quintile 1 to 5 of HDL-C/apoA-I ratio were: 1 (reference), 0.81 (0.49-1.361), 0.42 (0.23-0.77), 0.66 (0.38-1.14), and 0.82 (0.49-1.38), respectively. CONCLUSIONS There was a U-shaped association between HDL-C/apoA-I ratio and myocardial injury following PCI.
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Affiliation(s)
- Xiao-Lin Li
- Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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26
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Gordts SC, Muthuramu I, Nefyodova E, Jacobs F, Van Craeyveld E, De Geest B. Beneficial effects of selective HDL-raising gene transfer on survival, cardiac remodelling and cardiac function after myocardial infarction in mice. Gene Ther 2013; 20:1053-61. [PMID: 23759702 PMCID: PMC3821036 DOI: 10.1038/gt.2013.30] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 02/06/2013] [Accepted: 02/11/2013] [Indexed: 02/02/2023]
Abstract
Post-myocardial infarction (MI) ejection fraction is decreased in patients with low high-density lipoprotein (HDL) cholesterol levels, independent of the degree of coronary atherosclerosis. The objective of this study is to evaluate whether selective HDL-raising gene transfer exerts cardioprotective effects post MI. Gene transfer in C57BL/6 low-density lipoprotein receptor (LDLr)−/− mice was performed with the E1E3E4-deleted adenoviral vector AdA-I, inducing hepatocyte-specific expression of human apo A-I, or with the control vector Adnull. A ligation of the left anterior descending coronary artery was performed 2 weeks after transfer or saline injection. HDL cholesterol levels were persistently 1.5-times (P<0.0001) higher in AdA-I mice compared with controls. Survival was increased (P<0.01) in AdA-I MI mice compared with control MI mice during the 28-day follow-up period (hazard ratio for mortality 0.42; 95% confidence interval 0.24–0.76). Longitudinal morphometric analysis demonstrated attenuated infarct expansion and inhibition of left ventricular (LV) dilatation in AdA-I MI mice compared with controls. AdA-I transfer exerted immunomodulatory effects and increased neovascularisation in the infarct zone. Increased HDL after AdA-I transfer significantly improved systolic and diastolic cardiac function post MI, and led to a preservation of peripheral blood pressure. In conclusion, selective HDL-raising gene transfer may impede the development of heart failure.
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Affiliation(s)
- S C Gordts
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium
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27
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Patel PJ, Khera AV, Wilensky RL, Rader DJ. Anti-oxidative and cholesterol efflux capacities of high-density lipoprotein are reduced in ischaemic cardiomyopathy. Eur J Heart Fail 2013; 15:1215-9. [PMID: 23709232 DOI: 10.1093/eurjhf/hft084] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIMS Various pathological changes lead to the development of heart failure (HF). HDL is dysfunctional in both acute coronary syndrome, as measured by the HDL inflammatory index (HII) assay, and stable coronary disease, as measured by cholesterol efflux capacity. We therefore hypothesized that these functions of HDL are also impaired in subjects with ischaemic cardiomyopathy. METHODS AND RESULTS A case-control study was performed on subjects in the University of Pennsylvania Catheterization Study (PennCath) cohort of patients with angina. Cases had EF <50% and angiographic CAD (≥70% stenosis of any vessel; n = 23); controls included those with EF ≥55% and no CAD (n = 46). Serum from subjects was apolipoprotein-B depleted to isolate an HDL fraction. To measure HDL anti-oxidative capacity, the HDL fraction was incubated with LDL and a reporter lipid that fluoresces when oxidized. To measure cholesterol efflux capacity, the HDL fraction was also incubated with macrophages and tritium-labelled cholesterol. Mean HII was higher and efflux capacity lower in subjects with ischaemic cardiomyopathy (HII 0.26 vs. -0.028; efflux 0.80 vs. 0.92; P < 0.05). In a multivariable logistic regression model, both high HII and low efflux capacity were significant risk factors for HF [HII odds ratio (OR) 2.8, 95% confidence interval (CI) 2.0-3.9, P = 0.002; efflux OR 2.1, 95% CI 1.5-3.0, P = 0.03]. These effects persisted after adjustment for covariates and traditional risk factors for HF. CONCLUSION Subjects with reduced EF from ischaemia have lower HDL concentration and also impaired HDL function. HDL is a versatile lipoprotein particle with various anti-inflammatory and vasoprotective functions, whose impairment may contribute to ischaemic heart failure.
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Affiliation(s)
- Parin J Patel
- Division of Cardiology, Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Beta-blockers modify the prognostic value of adiponectin in chronic heart failure. Int J Cardiol 2011; 150:296-300. [DOI: 10.1016/j.ijcard.2010.04.039] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 04/05/2010] [Accepted: 04/15/2010] [Indexed: 11/22/2022]
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Abstract
The constellation of obesity, hypertension, dyslipidemia, and insulin resistance-together referred to as metabolic syndrome (MetS)-is increasing in prevalence in the American population and also worldwide. The individual components of MetS and MetS as a whole increase the risk of heart failure, cardiovascular mortality, and all-cause mortality. Despite this adverse association, numerous studies have documented an obesity paradox, in which overweight and obese people with established cardiovascular disease, including hypertension, coronary heart disease, heart failure, and peripheral arterial disease, have a better prognosis than patients who are not overweight or obese. Current treatment strategies for these patients include weight loss, control of blood pressure and cholesterol levels, and treatment of hyperglycemia. Because of increasing evidence for the obesity paradox, some physicians question whether obesity should be treated when it is associated with heart failure. Several studies have shown improvement in left ventricular function and decreased mortality and morbidity from heart failure with weight loss and treatment of elevated blood pressure, cholesterol, and hyperglycemia. The most reasonable approach at this time appears to be weight loss and exercise, lowering blood pressure to less than 130/80 mm Hg, low-density lipoprotein (LDL) cholesterol to less than 100 mg/dL, and glycosylated hemoglobin levels to less than 7%.
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Reed RM, Iacono A, DeFilippis A, Eberlein M, Girgis RE, Jones S. Advanced chronic obstructive pulmonary disease is associated with high levels of high-density lipoprotein cholesterol. J Heart Lung Transplant 2011; 30:674-8. [DOI: 10.1016/j.healun.2010.12.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 12/04/2010] [Accepted: 12/12/2010] [Indexed: 11/17/2022] Open
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Abstract
The cytokine hypothesis presently suggests that an excessive production of pro-inflammatory cytokines, such as tumour necrosis factor alpha (TNF) and interleukin 6 (IL6), contributes to the pathogenesis of heart failure. The concept, successfully proved in genetically modified animal models, failed to translate to humans. Recently, accumulation of apparently paradoxical experimental data demonstrates that, under certain conditions, production of pro-inflammatory cytokines can initiate the activation of a pro-survival cardioprotective signalling pathway. This novel path that involves the activation of a transcription factor, signal transducer and activator of transcription 3 (STAT3), has been termed the survival activating factor enhancement (SAFE) pathway. In this review, we will discuss whether targeting the SAFE pathway may be considered as a preventive and/or therapeutic measure for the treatment of heart failure.
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Affiliation(s)
- Sandrine Lecour
- Hatter Cardiovascular Research Institute, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
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Säemann MD, Poglitsch M, Kopecky C, Haidinger M, Hörl WH, Weichhart T. The versatility of HDL: a crucial anti-inflammatory regulator. Eur J Clin Invest 2010; 40:1131-43. [PMID: 20695882 DOI: 10.1111/j.1365-2362.2010.02361.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Low levels of plasma high-density lipoprotein (HDL) represent a major cardiovascular risk factor and therefore raising HDL has been proposed to positively affect patients with atherosclerotic heart disease. However, the current evidence that raising HDL per se will reduce atherosclerosis and thereby cardiovascular events still remains controversial. AIMS In this review, we discuss the diverse anti-atherogenic and anti-inflammatory properties of HDL in the light of recent findings indicating that the quality rather than the mere quantity of HDL determines its beneficial effects against atherosclerosis. More specifically, we will focus on the conspicuous anti-inflammatory properties of HDL as this might contribute to the overall beneficial effects of HDL in diseased patients such as modulation of costimulatory/adhesion molecule expression, cytokine production and inhibition of the prototypical proinflammatory transcription factor NF-κB. RESULTS A range of clinical disorders share permanent inflammation as a characteristic hallmark including coronary artery disease, chronic kidney disease, diabetes mellitus or rheumatoid arthritis and also display distinct qualitative changes in the HDL compartment. Loss of anti-inflammatory functions of HDL is emerging as an important risk factor for disease progression and survival in these clinical entities. CONCLUSIONS It will be important to define the anti-inflammatory effects of HDL at the molecular level and to dissect the manifold functional implications to develop both novel functional assays that enable meaningful outcome studies and foster new therapeutic concepts in patients with altered HDL function.
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Affiliation(s)
- Marcus D Säemann
- Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University Vienna, Währinger Gürtel, Vienna, Austria.
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Tang WHW, Wu Y, Mann S, Pepoy M, Shrestha K, Borowski AG, Hazen SL. Diminished antioxidant activity of high-density lipoprotein-associated proteins in systolic heart failure. Circ Heart Fail 2010; 4:59-64. [PMID: 21062973 DOI: 10.1161/circheartfailure.110.958348] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Diminished serum arylesterase activity, catalyzed by the high-density lipoprotein-associated paraoxonase-1, is associated with heightened systemic oxidative stress and atherosclerosis risk. In the present study, we sought to determine the prognostic role of serum arylesterase activity in subjects with systolic heart failure, particularly in relation to established cardiac biomarkers. METHODS AND RESULTS We measured serum arylesterase activity in 760 subjects with impaired left ventricular systolic function (left ventricular ejection fraction <50%), and prospectively followed major adverse cardiac events (including death, nonfatal myocardial infarction, and stroke) for 3 years. In our study cohort (mean age, 64±11 years; 74% men; median left ventricular ejection fraction, 35%; median creatinine clearance, 96 mg/dL), mean serum arylesterase activity (98±25 μmol/L/min/mL) was lower compared with that in healthy control subjects (mean, 115±26 μmol/L/min/mL, P<0.01) but higher compared with advanced decompensated heart failure subjects (mean, 69±22 μmol/L/min/mL, P<0.01). Within our cohort, there was modest correlation between serum arylesterase activity and high-density lipoprotein cholesterol (r=0.33, P<0.01) as well as B-type natriuretic peptide (r=-0.23, P<0.01). Lower serum arylesterase activity was a strong predictor of poorer outcomes (hazard ratio, 2.94; 95% confidence interval, 1.54, 5.62; P<0.001). After adjusting for traditional risk factors, medication use, B-type natriuretic peptide, and creatinine clearance, lower serum arylesterase still conferred an increased risk of major adverse cardiac events at 3 years (hazard ratio, 2.69; 95% confidence interval, 1.37 to 5.28; P=0.004). CONCLUSIONS In patients with systolic heart failure, decreased serum arylesterase activity, a measure of diminished antioxidant properties of high-density lipoprotein, predicts higher risk of incident long-term adverse cardiac event independent of established clinical and biochemical risk factors.
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Affiliation(s)
- W H Wilson Tang
- Center for Cardiovascular Diagnostics and Prevention, Department of Cell Biology, Lerner Research Institute, the Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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35
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Current world literature. Curr Opin Cardiol 2010; 25:411-21. [PMID: 20535070 DOI: 10.1097/hco.0b013e32833bf995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lizak MK, Zakliczynski M, Jarosz A, Zembala M. High-density lipoprotein cholesterol levels and risk of death in chronic heart failure patients referred for heart transplant evaluation. J Heart Lung Transplant 2010; 29:386-7. [DOI: 10.1016/j.healun.2009.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Accepted: 08/30/2009] [Indexed: 11/27/2022] Open
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The Year in Heart Failure. J Am Coll Cardiol 2010; 55:688-96. [DOI: 10.1016/j.jacc.2009.10.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Revised: 10/21/2009] [Accepted: 10/25/2009] [Indexed: 11/13/2022]
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Lavie CJ, Mehra MR. Statins and advanced heart failure--alive but barely breathing after CORONA and GISSI-HF. ACTA ACUST UNITED AC 2009; 15:157-8. [PMID: 19627287 DOI: 10.1111/j.1751-7133.2009.00089.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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