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Song X, Tong Y, Xian F, Luo Y, Tong R. Predicting 1 year readmission for heart failure: A comparative study of machine learning and the LACE index. ESC Heart Fail 2024; 11:2648-2660. [PMID: 38778700 PMCID: PMC11424322 DOI: 10.1002/ehf2.14855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/29/2024] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
AIMS There is a lack of tools for accurately identifying the risk of readmission for heart failure in elderly patients with arrhythmia. The aim of this study was to establish and compare the performance of the LACE [length of stay ('L'), acute (emergent) admission ('A'), Charlson comorbidity index ('C') and visits to the emergency department during the previous 6 months ('E')] index and machine learning in predicting 1 year readmission for heart failure in elderly patients with arrhythmia. METHODS Elderly patients with arrhythmia who were hospitalized at Sichuan Provincial People's Hospital between 1 June 2018 and 31 May 2020 were enrolled. The LACE index was calculated for each patient, and the area under the receiver operating characteristic curve (AUROC) was calculated. Six machine learning algorithms, combined with three variable selection methods and clinically relevant features available at the time of hospital discharge, were used to develop machine learning models. AUROC and area under the precision-recall curve (AUPRC) were used to assess discrimination. Shapley additive explanations (SHAP) analysis was used to explain the contributions of the features. RESULTS A total of 523 patients were enrolled, and 108 patients experienced 1 year hospital readmission for heart failure. The AUROC of the LACE index was 0.5886. The complete machine learning model had the best predictive performance, with an AUROC of 0.7571 and an AUPRC of 0.4096. The most important predictors for 1 year readmission were educational level, total triiodothyronine (TT3), aspartate aminotransferase/alanine aminotransferase (AST/ALT), number of medications (NOM) and triglyceride (TG) level. CONCLUSIONS Compared with the LACE index, the machine learning model can accurately identify the risk of 1 year readmission for heart failure in elderly patients with arrhythmia.
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Affiliation(s)
- Xuewu Song
- Department of PharmacySichuan Provincial People's Hospital, University of Electronic Science and Technology of ChinaChengduChina
| | - Yitong Tong
- Chengdu Second People's HospitalChengduChina
| | - Feng Xian
- Department of OncologyNanchong Central Hospital, the Second Clinical Medical College, North Sichuan Medical CollegeNanchongChina
| | - Yi Luo
- Department of PharmacySichuan Provincial People's Hospital, University of Electronic Science and Technology of ChinaChengduChina
| | - Rongsheng Tong
- Department of PharmacySichuan Provincial People's Hospital, University of Electronic Science and Technology of ChinaChengduChina
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Ran M, Li S, Lan J, Chen F, Wu D. Association of monocyte to HDL cholesterol ratio and a composite risk score with left ventricular aneurysm formation in patients with acute ST-segment elevation myocardial infarction. Coron Artery Dis 2024; 35:490-497. [PMID: 38682446 DOI: 10.1097/mca.0000000000001374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
BACKGROUND Left ventricular aneurysm (LVA) is an important complication of acute myocardial infarction. This study aimed to investigate the potential predictive value of the monocyte count to high-density lipoprotein cholesterol ratio (MHR) and a composite risk score in determining the formation of LVA in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention. METHODS We recruited 1005 consecutive patients with STEMI. Multivariable logistic regression analysis was conducted identify the independent risk factors for LVA formation. Predictive power of MHR and composite risk score for LVA formation were assessed using receiver operating characteristic curve analysis. RESULTS The MHR was significantly higher among patients with LVA compared to those without LVA [6.6 (3.8-10.8) vs. 4.6 (3.3-6.3), P < 0.001]. Univariable logistic regression analysis revealed that MHR (OR = 3.866, 95% CI = 2.677-5.582, P < 0.001) was associated with the risk of LVA formation. The predictive value of MHR remained significant even after multivariate logistic regression analysis [odds ratio (OR) = 4.801, 95% confidence interval (CI) = 2.672-8.629, P < 0.001]. The discriminant power of MHR for LVA is 0.712, which is superior to both monocyte ( C statistic = 0.553) and high-density lipoprotein cholesterol ( C statistic = 0.654). The composite risk score including MHR, gender, LVEF, hemoglobin, lymphocyte and left anterior descending artery as the culprit vessel could significantly increase the predictive ability ( C statistic = 0.920). CONCLUSION A higher MHR could effectively identify individuals at high risk of LVA formation, especially when combined with gender, LVEF, hemoglobin, lymphocyte and left anterior descending artery as the culprit vessel.
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Affiliation(s)
| | | | | | - Fengjuan Chen
- Department of Hematology, Panzhihua Central Hospital, Panzhihua, China
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Matin SS, Shidfar F, Naderi N, Amin A, Hosseini-Baharanchi FS, Dehnad A. The impact of synbiotic on serum sCD163/sTWEAK, paraoxonase 1, and lipoproteins in patients with chronic heart failure: a randomized, triple-blind, controlled trial. Sci Rep 2024; 14:19120. [PMID: 39155305 PMCID: PMC11330970 DOI: 10.1038/s41598-024-69560-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 08/06/2024] [Indexed: 08/20/2024] Open
Abstract
Cardiovascular disease is one of the leading causes of death worldwide. Evidence suggests that alterations in the gut microbiome could play a role in cardiovascular diseases, including heart failure. The purpose of this study was to evaluate the effect of synbiotics on serum paraoxonase 1(PON1), soluble CD163/soluble TNF-like weak inducer of apoptosis (sCD163/sTWEAK), and lipid profile, which are involved in heart failure in patients with chronic heart failure. In this triple-blind randomized clinical trial, 90 eligible patients were included in the study. They were randomly assigned to receive one capsule (500 mg) of synbiotics or a placebo daily for ten weeks. Serum PON1, sCD163/sTWEAK, and lipid profiles were measured at the beginning and end of the study. The data were analyzed by SPSS 24, and the p-value < 0.05 was considered statistically significant. Among 90 patients who met the inclusion criteria, 80 completed the study. The primary outcomes showed a small effect on sTWEAK, with an adjusted standard mean difference (SMD) of 0.2. However, no significant changes were observed in sCD163/sTWEAK (SMD: 0.16). Secondary outcomes indicated no changes in PON1, total cholesterol (TC), or LDL-C levels. However, there was an increase in HDL-C levels (adjusted SMD: 0.46, 95% CI: 0.02-0.91) and a decrease in TG and TC/HDL levels (adjusted SMD: - 0.5 and - 0.3, respectively) in the synbiotic group. A favorable effect of synbiotics on sTWEAK, HDL, TG, and TC/HDL of patients with heart failure was observed, but no statistically significant effect was found on sCD163/sTWEAK, PON1, LDL, and TC factors.
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Affiliation(s)
- Shakiba Shoaei Matin
- Nutritional Sciences Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Shidfar
- Nutritional Sciences Research Center, Iran University of Medical Sciences, Tehran, Iran.
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Nasim Naderi
- Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Amin
- Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Hosseini-Baharanchi
- Department of Biostatistics, School of Public Health, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Dehnad
- Department of Medical Education, School of Health Management and Information Sciences, Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
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Xing L, Liu Y, Wang J, Tian P, Liu P. High-Density Lipoprotein and Heart Failure. Rev Cardiovasc Med 2023; 24:321. [PMID: 39076447 PMCID: PMC11272862 DOI: 10.31083/j.rcm2411321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 07/31/2024] Open
Abstract
The protective effect of high-density lipoprotein (HDL) on atherosclerosis is well known, and its mechanisms of action has been extensively studied. However, the impact of HDL on heart failure and its mechanisms are still controversial or unknown. The cardioprotective role of HDL may be reflected in its antioxidant, anti-inflammatory, anti-apoptotic, and endothelial function protection. In epidemiological studies, high-density lipoprotein cholesterol (HDL-C) levels have been negatively associated with heart failure (HF). The major protein component of HDL-C is apolipoprotein (Apo) A-I, while paraoxonase-1 (PON-1) is an essential mediator for many protective functions of HDL, and HDL may act through components like (Apo) A-I or PON-1 to delay heart failure progress. HDL can slow heart failure disease progression through parts like (Apo) A-I or PON-1. The potential causality between HDL and heart failure, the role of HDL in the pathogenesis of HF, and its interaction with C-reactive protein (CRP), triglycerides (TG), and monocytes in the process of heart failure have been briefly summarized and discussed in this article. HDL plays an important role in the pathogenesis, progression and treatment of HF.
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Affiliation(s)
- Liyun Xing
- Department of Cardiology, the Second Hospital of Shandong University,
250033 Jinan, Shandong, China
| | - Yixuan Liu
- School of Clinical and Basic Medicine, Shandong First Medical University,
250117 Jinan, Shandong, China
| | - Jiayu Wang
- Department of Cardiology, the Second Hospital of Shandong University,
250033 Jinan, Shandong, China
| | - Peiqing Tian
- Department of Cardiology, the Second Hospital of Shandong University,
250033 Jinan, Shandong, China
| | - Ping Liu
- Department of Cardiology, the Second Hospital of Shandong University,
250033 Jinan, Shandong, China
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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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Du S, Su Y, Zhang D, Wu J, Zheng H, Wang X. Joint effects of self-reported sleep and modifiable physical activity on risk of dyslipidaemia in women aged 45-55 years: a cross-sectional study. BMJ Open 2022; 12:e049351. [PMID: 34996783 PMCID: PMC8744097 DOI: 10.1136/bmjopen-2021-049351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Modifiable physical activity (PA) plays an important role in dyslipidaemia risk in middle-aged women with sleep problems, especially perimenopausal women. We aimed to explore the joint effects of sleep and PA on the risk of dyslipidaemia in women aged 45-55 years, and the extent to which PA moderated the effect of sleep on the risk of dyslipidaemia. DESIGN A cross-sectional study. SETTING This study was based on the survey of Chronic Disease and Nutrition Monitoring in Adults in Inner Mongolia in 2015. PARTICIPANTS 721 women aged 45-55 years were included. OUTCOME MEASUREMENT PA was measured by the Global Physical Activity Questionnaire. Sleep was measured by questionnaire formulated by the Chinese Center for Disease Control and Prevention. Multivariate logistic regression analyses were performed to determine the joint effects of sleep and PA on dyslipidaemia risk. OR and 95% CI were reported. RESULTS Among all participants, 60.6% had sleep problems, 29.0% had low PA and 41.1% had dyslipidaemia. Women with sleep problems had higher dyslipidaemia risk than women without sleep problems, irrespective of low, moderate or high PA, with OR (95% CI) of 4.24 (2.40 to 7.49), 3.14 (1.80 to 5.49) and 2.04 (1.20 to 3.48), respectively. PA could not completely attenuate the negative association between sleep and dyslipidaemia risk. With PA increased from low to high, the OR of dyslipidaemia decreased by 2.20. Women with sleep problems and low PA had higher risks of high total cholesterol, high triglyceride, low high-density lipoprotein cholesterol and high low-density lipoprotein cholesterol than women without sleep problems and high PA, with OR (95% CI) of 2.51 (1.18 to 5.35), 2.42 (1.23 to 4.74), 2.88 (1.44 to 5.74) and 2.52 (1.12 to 5.70), respectively. CONCLUSIONS Among women aged 45-55 years, the joint effects of self-reported sleep and PA on dyslipidaemia risk were more marked for sleep than for PA. Modifiable PA is a widely accessible and effective intervention to reduce the dyslipidaemia risk in women with sleep problems, particularly among perimenopausal women.
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Affiliation(s)
- Sha Du
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Yuenan Su
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Dongxue Zhang
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Jing Wu
- National Institute for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huiqiu Zheng
- Department of Child and Adolescent Health and Health Education, School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Xuemei Wang
- Department of Health Statistics, School of Public Health, Inner Mongolia Medical University, Hohhot, China
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Wang Q, Lin Z, Chen H, Ma T, Pan B. Effect of Cytochrome P450 Family 2 Subfamily R Member 1 Variants on the Predisposition of Coronary Heart Disease in the Chinese Han Population. Front Cardiovasc Med 2021; 8:652729. [PMID: 34262949 PMCID: PMC8273490 DOI: 10.3389/fcvm.2021.652729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/17/2021] [Indexed: 12/03/2022] Open
Abstract
Propose: Cytochrome P450 family 2 subfamily R member 1 (CYP2R1) variations can affect the activity of 25-hydroxylase, resulting in the deficiency of 25(OH)D, which leads to an increased incidence and mortality of coronary heart disease (CHD). The purpose is to assess the influence of CYP2R1 variants on CHD risk among the Chinese Han population. Methods: A total of 508 CHD patients and 510 healthy controls were enrolled. The MassARRAY platform completed genotyping of CYP2R1 variants. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated using logistic regression analysis. Results: Rs6486205 (OR = 1.25, 95% CI: 1.05–1.50, p = 0.014), rs10741657 (OR = 1.29, 95% CI: 1.08–1.54, p = 0.005), and rs2060793 (OR = 1.27, 95% CI: 1.06–1.51, p = 0.009) were associated with the increased susceptibility to CHD in the whole subjects. Interestingly, the relationships between these variants and CHD risk were observed in the subjects with age >60 years, males or non-smoker. Additionally, the haplotypes Ars10741657Ars2060793 and Grs10741657Grs2060793 had the higher risk of CHD, and the combination (rs6486205 and rs10741657) was the best multi-locus model. Conclusion: Our study suggested the contribution of CYP2R1 polymorphisms to the increased CHD predisposition in the Chinese Han population. Furthermore, the risk association was related to confounding factors for CHD, including age, sex, and smoking. These findings might help to strengthen the understanding of the CYP2R1 gene in the occurrence of CHD.
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Affiliation(s)
- Qi Wang
- Department of General Practice, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Zhen Lin
- Department of Geriatrics, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Hairong Chen
- Department of General Practice, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Tianyi Ma
- Department of Cardiovasology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
| | - Biyun Pan
- Department of General Practice, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, China
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Abstract
Background The association between free triiodothyronine (FT3) and long-term prognosis in dilated cardiomyopathy (DCM) patients has not been evaluated. The purpose of this study was to determine whether the level of FT3 could provide prognostic value in patients with DCM. Methods Data of consecutive patients diagnosed with DCM were collected from October 2009 to December 2014. FT3 was measured by fluoroimmunoassay. Other biochemical markers, such as free thyroxin (FT4), thyroid-stimulating hormone, red blood cell, hemoglobin, blood urea nitrogen, and serum creatinine, were tested at the same time. Follow-up was performed every 3 months. The primary endpoint was all-cause mortality. Pearson analysis was used to evaluate the correlation of FT3 and other lab metrics with DCM patients’ prognosis. The association of long-term mortality in DCM and FT3 was compared using Cox hazards model. Results Data of 176 patients diagnosed with DCM were collected. Of them, 24 patients missed FT3 values and six patients were lost to follow-up. Altogether, data of 146 patients were analyzed. During the median follow-up time of 79.9 (53.5–159.6) months, nine patients lost, 61 patients died (non-survival group), and 85 patients survived (survival group). FT3 was significantly lower in non-survival group than that in survival group (3.65 ± 0.83 pmol/L vs. 4.36 ± 1.91 pmol/L; P = 0.003). FT3 also showed a significantly positive correlation with red blood cell and hemoglobin, negatively correlated with age, blood urea nitrogen and serum creatinine (P < 0.05), respectively. Patients in the group of lower FT3 levels (FT3 ≤3.49 pmol/L) suffered from a higher risk of all-cause mortality (P for log-rank = 0.001). In multivariate Cox regression analysis, FT3 level was significantly associated with all-cause mortality (hazard ratio: 0.70, 95% confidence interval 0.52–0.95, P for trend = 0.021). Conclusion Low levels of FT3 were associated with increased all-cause mortality in patients with DCM.
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Sakatani T, Nakajima K, Fujita H, Nishimura T. Cardiovascular event risk estimated after coronary revascularization and optimal medical therapy: J-ACCESS4 prognostic study. Ann Nucl Med 2021; 35:241-252. [PMID: 33389665 PMCID: PMC7895784 DOI: 10.1007/s12149-020-01558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/23/2020] [Indexed: 11/28/2022]
Abstract
Background An assessment of cardiac events and survival using quantitative gated myocardial single-photon emission computed tomography (SPECT) (J-ACCESS) associated several risk factors with cardiac events in Japan. The clinical course after revascularization and/or optimal medical therapy (OMT) was followed in patients with coronary artery disease (CAD) at moderate-to-high risk estimated by software incorporating the J-ACCESS risk model. The present study aimed to determine the relevance of changes in estimated risk to outcomes of these therapies. Methods This study included 494 patients with possible or definite CAD who underwent initial pharmacological stress 99mTc-tetrofosmin myocardial perfusion SPECT (MPS) before and eight months after therapy. Major cardiac event risk during 3 years of follow-up was calculated using an equation based on that in the J-ACCESS study. Patients with ≥ 10% cardiac event risk estimated at the first MPS (n = 31) were analyzed and followed up for at least 1 year. Results Estimated risk was reduced by ≥ 5% in 14 patients (45%) after therapy. During a follow-up period of 22.1 ± 6.7 months, one patient without such reduction had a major cardiac event. Mean %summed stress scores significantly decreased from baseline to follow-up in patients with and without risk reduction. Left ventricular ejection fraction (LVEF [%]) at rest was significantly increased at the second, compared with the first MPS between patients with, than without risk reduction (57 ± 17 vs. 45 ± 16%, p = 0.001 and 50 ± 11 vs. 49 ± 9%, p = 0.953, respectively). Conclusions A reduction in cardiac ischemia and an increase in LVEF by revascularization and/or OMT were necessary to avoid cardiac events among patients with moderate-to-high estimated risk, and changes in event risk were quantifiable.
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Affiliation(s)
- Tomohiko Sakatani
- Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-Cho, Kamigyo-Ku, Kyoto, 602-8026, Japan
| | - Kenichi Nakajima
- Department of Functional Imaging and Artificial Intelligence, Kanazawa University, Kanazawa, Japan
| | - Hiroshi Fujita
- Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, 355-5 Haruobi-Cho, Kamigyo-Ku, Kyoto, 602-8026, Japan
| | - Tsunehiko Nishimura
- Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawara-Machi Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.
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Mondal H, Mondal S, Samantaray R, Das D, Biri S, Naskar A, Jana S. Atherogenic index of plasma and left ventricular ejection fraction in newly diagnosed type 2 diabetes mellitus patients. Res Cardiovasc Med 2021. [DOI: 10.4103/rcm.rcm_16_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zieliński K, Kalińczuk Ł, Chmielak Z, Mintz GS, Dąbrowski M, Pręgowski J, Świerczewski M, Kowalik I, Demkow M, Hryniewiecki T, Michałowska I, Witkowski A. Additive Value of High-Density Lipoprotein Cholesterol and C-Reactive Protein Level Assessment for Prediction of 2-year Mortality After Transcatheter Aortic Valve Implantation. Am J Cardiol 2020; 126:66-72. [PMID: 32340714 DOI: 10.1016/j.amjcard.2020.03.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/27/2020] [Accepted: 03/27/2020] [Indexed: 12/13/2022]
Abstract
Available prediction models are inaccurate in elderly who underwent transcatheter aortic valve implantation (TAVI). The aim of present study was to analyze the separate and combined prognostic values of baseline HDL-C and C-reactive protein (CRP) levels in patients treated successfully with TAVI who had complete 2-year follow-up. We analyzed 334 patients treated with TAVI from 01/2010 to 07/2017 who had measurements of HDL-C and CRP on admission or during qualification for the procedure. Baseline HDL-C ≤46 mg/dl (areas under the curve [AUC] = 0.657) and CRP ≥0.20 mg/dl (AUC = 0.634) were predictive of 2-year mortality. After stratification with both cutoffs, patients with low HDL-C and concomitant high CRP most often had LVEF ≤50% and were high risk as per EuroSCORE II. Those with isolated CRP elevation had the lowest frequency of LVEF ≤50%, but more sarcopenia (based on psoas muscle area). After adjustment in the multivariate analysis for other identified predictors including EuroSCORE II and statin therapy, isolated HDL-C ≤46 mg/dl (identified in 40 patients) and isolated CRP ≥0.20 mg/dl (n = 109) were both independent predictors of 2-year mortality (hazard ratio [HR] = 2.92 and HR = 2.42, respectively) compared with patients with both markers within established cutoffs (n = 105) who had the lowest 2-year mortality (9.5%). Patients with both markers exceeding cutoffs (n = 80) had the highest risk (HR = 4.53) with 2-year mortality of 42.5%. High CRP was associated with increased mortality within the first year of follow-up, whereas low HDL-C increased mortality in the second year. The combination of both markers with EuroSCORE II enhanced mortality prediction (AUC = 0.697). In conclusion, low baseline HDL-C and high CRP jointly contribute to the prediction of increased all-cause mortality after TAVI.
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Wawrzeńczyk A, Anaszewicz M, Wawrzeńczyk A, Budzyński J. Clinical significance of nutritional status in patients with chronic heart failure-a systematic review. Heart Fail Rev 2020; 24:671-700. [PMID: 31016426 DOI: 10.1007/s10741-019-09793-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chronic heart failure (CHF) and nutritional disorders are recognized as major challenges for contemporary medicine. This study aims to estimate the role of nutritional disorders as risk factors for CHF development and prognostic factors for CHF patients and the outcome of nutritional intervention in CHF. Full-text English articles published between January 2013 and February 2019 available in the PubMed and Scopus databases were considered. Seventy-five prospective, retrospective, and cross-sectional studies as well as meta-analyses on patients with CHF, reporting correlation of their nutritional status with the risk and prognosis of CHF and the outcome of nutritional interventions in CHF were all included. Higher BMI increases the risk of CHF by 15-70%, especially when associated with severe, long-lasting and abdominal obesity. Overweight and obesity are associated with the reduction of mortality in CHF by 24-59% and 15-65%, respectively, and do not affect the outcome of invasive CHF treatment. Malnutrition increases the risk of mortality (by 2- to 10-fold) and the risk of hospitalization (by 1.2- to 1.7-fold). Favorable outcome of nutritional support in CHF patients was reported in a few studies. Nutritional disorders are prevalent in patients with CHF and play a significant role in the incidence, course, and prognosis of the disease. The existence of an "obesity paradox" in patients with CHF was confirmed. Further studies on the effect of nutritional support and body weight reduction in patients with CHF are necessary.
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Affiliation(s)
- Anna Wawrzeńczyk
- Department of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland. .,Department of Vascular and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, 75 Ujejskiego Street, 85-168, Bydgoszcz, Poland.
| | - Marzena Anaszewicz
- Department of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Adam Wawrzeńczyk
- Department of Allergology, Clinical Immunology and Internal Diseases, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Jacek Budzyński
- Department of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
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Li YP, Wang CY, Shang HT, Hu RR, Fu H, Xiao XF. A high-throughput and untargeted lipidomics approach reveals new mechanistic insight and the effects of salvianolic acid B on the metabolic profiles in coronary heart disease rats using ultra-performance liquid chromatography with mass spectrometry. RSC Adv 2020; 10:17101-17113. [PMID: 35521479 PMCID: PMC9053481 DOI: 10.1039/d0ra00049c] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/12/2020] [Indexed: 12/11/2022] Open
Abstract
High-throughput lipidomics provides the possibility for the development of new therapeutic drugs. Accordingly, herein, we reveal the protective role of salvianolic acid B (Sal B) in rats with coronary heart disease (CHD) and propose a new mechanism for its action through a high-throughput and non-targeted lipidomics strategy. A CHD animal model was induced by consecutive high-fat diet feeding with vitamin D3 injection. At the end of the 8th week, the serum sample was analyzed to explore the metabolic biomarker and pathway changes using untargeted lipidomics based on ultra-performance liquid chromatography with mass spectrometry (UPLC/MS). In addition, blood and heart tissue samples were collected and processed for the detection of biochemical indicators and liver histological observation. After salvianolic acid B treatment, the levels of LDH, CK, CK-MB, MYO, CTn1, TG, TC, LDL-c, and Apo(b) were significantly lower than that in the model group, while the levels of HDL-c and Apo(a1) were significantly higher than that in the model group. Furthermore, the histological features of fibrosis and steatosis were also evidently relieved in the model group. A total of twenty-six potential biomarkers were identified to express the lipid metabolic turbulence in the CHD animal models, of which twenty-two were regulated by salvianolic acid B trending to the normal state, including TG(20:0/20:4/o-18:0), PC(20:4/18:1(9Z)), PC(18:3/20:2), PA(18:0/18:2), LysoPE(18:2/0:0), SM(d18:0/22:1), PE(22:6/0:0), LysoPE (20:4/0:0), sphinganine, Cer(d18:0/18:0), PS(14:0/14:1), PC (18:0/16:0), LysoPC(17:0), PE(22:2/20:1), PC(20:3/20:4), PE(20:4/P-16:0), PS(20:3/18:0), cholesterol sulfate, TG(15:0/22:6/18:1), prostaglandin E2, arachidonic acid and sphingosine-1-phosphate. According to the metabolite enrichment and pathway analyses, the pharmacological activity of salvianolic acid B on CHD is mainly involved in three vital metabolic pathways including glycerophospholipid metabolism, sphingolipid metabolism and arachidonic acid metabolism. Thus, based on the lipidomics-guided biochemical analysis of the lipid biomarkers and pathways, Sal B protects against CHD with good therapeutic effect by regulating glycerophospholipid metabolism, sphingolipid metabolism and arachidonic acid metabolism, inhibiting oxidative stress damage and lipid peroxidation. High-throughput lipidomics provides the possibility for the development of new therapeutic drugs.![]()
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Affiliation(s)
- Ying-Peng Li
- Tianjin University of Traditional Chinese Medicine Tianjin 301617 China
| | - Cong-Ying Wang
- Tianjin University of Traditional Chinese Medicine Tianjin 301617 China
| | - Hong-Tao Shang
- Tianjin University of Traditional Chinese Medicine Tianjin 301617 China
| | - Rui-Rui Hu
- Tianjin University of Traditional Chinese Medicine Tianjin 301617 China
| | - Hui Fu
- Tianjin University of Traditional Chinese Medicine Tianjin 301617 China
| | - Xue-Feng Xiao
- Tianjin University of Traditional Chinese Medicine Tianjin 301617 China
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14
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Hypolipidemic and Hepatoprotective Effects of High-Polydextrose Snack Food on Swiss Albino Mice. J Nutr Metab 2020; 2020:5104231. [PMID: 32257429 PMCID: PMC7097762 DOI: 10.1155/2020/5104231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/31/2020] [Accepted: 02/13/2020] [Indexed: 11/24/2022] Open
Abstract
In this study, the hepatoprotective and hypolipidemic effects of high-polydextrose snack food on Swiss albino mice were investigated. The mice were randomly divided into three groups: control diet, high-fat diet, and high-fat and fiber diet groups. Addition of high-polydextrose snack to the high-fat diet resulted in significant reduction in the liver weight, the accumulation of lipid droplets in liver, and the liver damage of hyperlipidemic mice in comparison with the high-fat diet. The high-polydextrose snack also decreased the content of total triglyceride, cholesterol, and low-density lipoprotein cholesterol as well as the alanine aminotransferase and aspartate aminotransferase activities in the mice serum. In addition, the high-polydextrose snack significantly increased the high-density lipoprotein cholesterol content of the hyperlipidemic mice. Consequently, use of high-polydextrose snack generated hepatoprotective and hypolipidemic effects on hyperlipidemic mice.
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Mayala HA, Mafuru M, Mkangala A, Mayala M, Pallangyo P, Minja D, Janabi M, Zhao-Hui W. Factors influencing left ventricular ejection fraction in patients with coronary microvascular disease and obstructive coronary artery disease. BMC Res Notes 2020; 13:157. [PMID: 32178717 PMCID: PMC7077157 DOI: 10.1186/s13104-020-05008-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 03/11/2020] [Indexed: 11/15/2022] Open
Abstract
Objective The aim of our research was to evaluate the relationship involving left ventricular ejection fraction, low density lipoprotein, B-type natriuretic peptide, Troponin I and coronary flow reserve, and to determine the predictors of left ventricular ejection fraction in patients with coronary microvascular disease and obstructive coronary artery disease, and in patients with coronary microvascular disease. Results The mean age was 58.5 ± 12.5 years. In patients with obstructive coronary disease and coronary microvascular disease we found low density lipoprotein-c had significant inverse relationship with left ventricular ejection fraction, left ventricular ejection fraction also had significant negative relationship with B-type natriuretic peptide, and Troponin-I. While a significant direct relationship turned out to be observed linking left ventricular ejection fraction with coronary flow reserve. Left ventricular ejection fraction had significant negative relationship with low density lipoprotein, and B-type natriuretic peptide in patients with obstructive coronary artery disease only. Age, blood pressure, lipid levels, red cell distribution width, glycated hemoglobin, symptoms, New York heart association classification, alcohol drinking, hypertension, diabetes mellitus, troponin levels and B-type natriuretic peptide were the predictors for left ventricular ejection fraction in coronary microvascular disease patients.
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Affiliation(s)
- Henry Anselmo Mayala
- Jakaya Kikwete Cardiac Institute, P. O. Box 65141, West Upanga, Kalenga Street, Ilala District, Dar es Salaam, Tanzania.
| | - Magesa Mafuru
- Tongji Medical College, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, 43000, Hubei, China
| | - Abdalah Mkangala
- Jakaya Kikwete Cardiac Institute, P. O. Box 65141, West Upanga, Kalenga Street, Ilala District, Dar es Salaam, Tanzania
| | - Mark Mayala
- Muhimbili University of Health and Allied Science, Upanga, Ilala District, Dar es Salaam, Tanzania
| | - Pedro Pallangyo
- Jakaya Kikwete Cardiac Institute, P. O. Box 65141, West Upanga, Kalenga Street, Ilala District, Dar es Salaam, Tanzania
| | - Dickson Minja
- Jakaya Kikwete Cardiac Institute, P. O. Box 65141, West Upanga, Kalenga Street, Ilala District, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Jakaya Kikwete Cardiac Institute, P. O. Box 65141, West Upanga, Kalenga Street, Ilala District, Dar es Salaam, Tanzania
| | - Wang Zhao-Hui
- Tongji Medical College, Huazhong University of Science and Technology, 1037 Luoyu Road, Wuhan, 43000, Hubei, China
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16
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Sirtori CR, Ruscica M, Calabresi L, Chiesa G, Giovannoni R, Badimon JJ. HDL therapy today: from atherosclerosis, to stent compatibility to heart failure. Ann Med 2019; 51:345-359. [PMID: 31729238 PMCID: PMC7877888 DOI: 10.1080/07853890.2019.1694695] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Epidemiologically, high-density lipoprotein (HDL) cholesterol levels have been inversely associated to cardiovascular (CV) events, although a Mendelian Randomisation Study had failed to establish a clear causal role. Numerous atheroprotective mechanisms have been attributed to HDL, the main being the ability to promote cholesterol efflux from arterial walls; anti-inflammatory effects related to HDL ligands such as S1P (sphingosine-1-phosphate), resolvins and others have been recently identified. Experimental studies and early clinical investigations have indicated the potential of HDL to slow progression or induce regression of atherosclerosis. More recently, the availability of different HDL formulations, with different phospholipid moieties, has allowed to test other indications for HDL therapy. Positive reports have come from studies on coronary stent biocompatibility, where the use of HDL from different sources reduced arterial cell proliferation and thrombogenicity. The observation that low HDL-C levels may be associated with an enhanced risk of heart failure (HF) has also suggested that HDL therapy may be applied to this condition. HDL infusions or apoA-I gene transfer were able to reverse heart abnormalities, reduce diastolic resistance and improve cardiac metabolism. HDL therapy may be effective not only in atherosclerosis, but also in other conditions, of relevant impact on human health.Key messagesHigh-density lipoproteins have as a major activity that of removing excess cholesterol from tissues (particularly arteries).Knowledge on the activity of high-density lipoproteins on health have however significantly widened.HDL-therapy may help to improve stent biocompatibility and to reduce peripheral arterial resistance in heart failure.
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Affiliation(s)
- C R Sirtori
- Dyslipidemia Center, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - M Ruscica
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - L Calabresi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - G Chiesa
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - R Giovannoni
- Department of Biology, University of Pisa, Pisa, Italy
| | - J J Badimon
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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17
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PREDICTORS OF WEIGHT LOSS IN PATIENTS WITH CHRONIC HEART FAILURE AND REDUSED LEFT VENTRICULAR EJECTION FRACTION. EUREKA: HEALTH SCIENCES 2019. [DOI: 10.21303/2504-5679.2019.00999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Chronic heart failure (CHF) is a heterogeneous syndrome with a poor prognosis.
Aim of the work – to define predictors of body weight (BW) loss in patients with CHF and a reduced left ventricular ejection fraction (LVEF).
Materials and methods. 120 patients with stable CHF and LVEF ≤35 %, II-IV NYHA class were examined. Patients were divided into two groups according to the value of BW loss for 6 months: the first group - loss of BW <6 %, the second - ≥ 6 %.
Results. Out of the 120 patients who were studied, a BW loss of ≥ 6 % occurred in 59 (49.2 %) patients. According to the results of binary logistic regression, predictors of BW loss of ≥6 % in patients with CHF and LVEF ≤ 35 % were: age, coronary heart disease, anaemia, and the number of hospitalizations over the last year. People with poorer quality of life, bigger number of points on the Beck depression scale and DEFS, with lower levels of physical activity and worse endothelium-dependent vasodilator response; higher sizes of the right atrium, right ventricle, and pulmonary artery systolic pressure, E / E '. Higher levels of C-reactive protein (CRP), uric acid are associated with a risk of losing BW≥6 %.
Conclusions. Weight loss ≥ 6 % is observed in 49.2 % of patients with CHF and LVEF≤35 %. According to multivariate analysis, independent predictors of BW loss of ≥6 % in patients with CHF and LVEF≤35 % are age, CRP level, III-IV NYHA class, lower cholesterol levels, as well as lower rates of flow-dependent vasodilator response and hip circumference.
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Cheng PC, Hsu SR, Li JC, Chen CP, Chien SC, Tu ST, Cheng YC, Liu YH, Kuo JF. Plasma Low-Density Lipoprotein Cholesterol Correlates With Heart Function in Individuals With Type 2 Diabetes Mellitus: A Cross-Sectional Study. Front Endocrinol (Lausanne) 2019; 10:234. [PMID: 31031709 PMCID: PMC6470411 DOI: 10.3389/fendo.2019.00234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 03/25/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Heart failure is a frequent complication of type 2 diabetes mellitus (T2DM). Plasma cholesterol, particularly the proatherogenic low-density lipoprotein (LDL) cholesterol, impairs heart function by promoting atheroma formation and ventricular dysfunction. Considering the established effect of cholesterol on the cardiovascular system, we hypothesized that plasma LDL cholesterol may influence left ventricular function in individuals with T2DM. Methods: This cross-sectional study was conducted at a tertiary care hospital in Taiwan. Enrollment criteria were patients exceeding 21 years of age with T2DM who received antidiabetic and cholesterol-lowering medications. Candidates were excluded if they had heart failure, acute cardiovascular events, or familial hypercholesterolemia. Participants received blood sampling for plasma lipids after a 12-h fast, followed by transthoracic echocardiography in the cardiology clinic. Results: The study enrolled 118 participants who were divided into two groups according to their plasma LDL cholesterol levels. Demographic characteristics including age (69.7 vs. 66.9 years, P = 0.159), body mass index (26.2 vs. 25.9 kg/m2, P = 0.66), diabetes duration (5.4 vs. 5.1 years, P = 0.48), hemoglobin A1c (7.2 vs. 7.5%, P = 0.225), and systolic blood pressure (129 vs. 130 mm Hg, P = 0.735) were similar between these groups. Moreover, all participants received similar antihypertensive medications. Participants with lower plasma LDL cholesterol levels had better heart function, as measured by the left ventricular ejection fraction (LVEF), than patients with higher LDL cholesterol levels (58.0 vs. 50.5%, P = 0.022). Multivariate regression analysis also showed an inverse correlation between plasma LDL cholesterol and left ventricular function (β coefficient: -0.110, P = 0.024). Conclusion: This study observed an inverse correlation between plasma LDL cholesterol and heart function in individuals with T2DM. Patients with higher levels of plasma LDL cholesterol had worse left ventricular function. Therefore, plasma LDL cholesterol may be a modifiable risk factor of heart failure in diabetes, but prospective studies are necessary to confirm this finding.
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Affiliation(s)
- Po-Chung Cheng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Shang-Ren Hsu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Jung-Chi Li
- Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ching-Pei Chen
- Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Szu-Chi Chien
- Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Shih-Te Tu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yun-Chung Cheng
- Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Hsiu Liu
- Department of Accounting and Information Systems, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Jeng-Fu Kuo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
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Liu Y, Hao Z, Xiao C, Liu L, Liao H. Association of serum total cholesterol and left ventricular ejection fraction in patients with heart failure caused by coronary heart disease. Arch Med Sci 2018; 14:988-994. [PMID: 30154879 PMCID: PMC6111365 DOI: 10.5114/aoms.2017.70660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 09/10/2017] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION The aim was to evaluate the association of serum total cholesterol (TC) level and left ventricular ejection fraction (LVEF) in patients with heart failure (HF) caused by coronary heart disease (CHD). MATERIAL AND METHODS A total of 236 participants were enrolled. Participants were divided into severely reduced (≤ 35%) and moderately reduced (> 35%) LVEF groups and the between-group difference was evaluated. Multivariate regression analysis was used to evaluate the association between LVEF and parameters of interest. Linear regression analysis was applied to analyze the odds ratio of per 1-SD increase in serum TC level for LVEF change. RESULTS Mean age was 57.3 years and males accounted for 58.1%. Mean serum TC level was 4.6 mmol/l, albumin (ALB) 33.6 g/l, and C-reactive protein (CRP) 11.4 mg/l. Mean LVEF was 38.3%. Compared to high-reduced LVEF group, participants in moderate-reduced LVEF group had significantly higher TC (4.8 ±0.9 mmol/l vs. 4.4 ± 0.7 mmol/l) and ALB (35.8 ±6.7 g/l vs. 31.4 ±6.0 g/l) but lower CRP (9.6 ±4.7 mg/l vs. 14.2 ±7.0 mg/l) levels (p < 0.05 for all comparisons). Increased TC and ALB levels were associated with higher LVEF, and increased CRP level was associated with lower LVEF. After adjusted for CRP, although per 1-SD increase in TC level was still associated with an increment in 4 % in LVEF, it did not achieve achieve statistic significance. CONCLUSIONS In patients with HF caused by CHD, higher serum TC level appeared to be associated with higher LVEF, which might be associated with systemic inflammation improvement.
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Affiliation(s)
- Yan Liu
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China
| | - Zirui Hao
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China
| | - Chun Xiao
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China
| | - Ling Liu
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China
| | - Huocheng Liao
- Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China
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Xu L, Zhao G, Wang J, Shen C, Li X, Lu F, Jiang H, Liu G, Hu K, Tang Y, Sun A, Ge J. Impact of Genetic Variation in Aldehyde Dehydrogenase 2 and Alcohol Consumption on Coronary Artery Lesions in Chinese Patients with Stable Coronary Artery Disease. Int Heart J 2018; 59:689-694. [DOI: 10.1536/ihj.17-165] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Lei Xu
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Gang Zhao
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Jingfeng Wang
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Cheng Shen
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Xiao Li
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Fei Lu
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University
| | - Hongfa Jiang
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University
| | - George Liu
- Institute of Cardiovascular Science, Key Laboratory of Molecular Cardiovascular Sciences, Peking University Health Science Center
| | - Kai Hu
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
| | - Yanhua Tang
- Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University
| | - Aijun Sun
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
- Institute of Biomedical Science, Fudan University
| | - Junbo Ge
- Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University
- Institute of Biomedical Science, Fudan University
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