■肺动脉高压(PH)的血脂失调。较低的高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)与PH中的疾病严重程度和死亡有关。右心室(RV)功能障碍和衰竭是PH发病率和死亡率的主要决定因素。这项研究旨在验证以下假设:血脂异常与PH中的RV功能障碍有关。
■我们登记了健康对照受试者(n=12)和患有PH的个体(n=30)(年龄:18-65岁)。临床特征,超声心动图,2-[18F]氟-2-脱氧-D-葡萄糖正电子发射断层扫描(PET)扫描,血脂,包括总胆固醇(TC),甘油三酯(TG),脂蛋白(LDL-C和HDL-C),测定N末端B型利钠肽前体(NT-proBNP)。
■患有PH的人HDL-C较低[PH,41±12;对照,56±16mg/dL,p<0.01]和更高的TG与HDL-C比率[PH,3.6±3.1;对照,与对照相比,2.2±2.2,p<0.01]。TC,TG,PH和对照组的LDL-C相似。较低的TC和TG与RV应变测量的RV功能较差相关(分别为R=-0.43,p=0.02和R=-0.37,p=0.05),右心室面积分数变化(R=0.51,p<0.01,R=0.48,p<0.01),右心室收缩末期面积(R=-0.63,p<0.001,R=-0.48,p<0.01),RV舒张末期面积:R=-0.58,p<0.001和R=-0.41,p=0.03),和PET对RV葡萄糖的摄取(分别为R=-0.46,p=0.01和R=-0.30,p=0.10)。PH患者NT-proBNP与TC(R=-0.61,p=0.01)、TG(R=-0.62,p<0.02)呈负相关。
■这些发现证实了血脂异常与PH患者右心室功能恶化有关。
UNASSIGNED: Blood lipids are dysregulated in pulmonary hypertension (PH). Lower high-density lipoproteins cholesterol (HDL-C) and low-density lipoproteins cholesterol (LDL-C) are associated with disease severity and death in PH. Right ventricle (RV) dysfunction and failure are the major determinants of morbidity and mortality in PH. This study aims to test the hypothesis that dyslipidemia is associated with RV dysfunction in PH.
UNASSIGNED: We enrolled healthy control subjects (n=12) and individuals with PH (n=30) (age: 18-65 years old). Clinical characteristics, echocardiogram, 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (PET) scan, blood lipids, including total cholesterol (TC), triglycerides (TG), lipoproteins (LDL-C and HDL-C), and N-terminal pro-B type Natriuretic Peptide (NT-proBNP) were determined.
UNASSIGNED: Individuals with PH had lower HDL-C [PH, 41±12; control, 56±16 mg/dL, p<0.01] and higher TG to HDL-C ratio [PH, 3.6±3.1; control, 2.2±2.2, p<0.01] as compared to controls. TC, TG, and LDL-C were similar between PH and controls. Lower TC and TG were associated with worse RV function measured by RV strain (R=-0.43, p=0.02 and R=-0.37, p=0.05 respectively), RV fractional area change (R=0.51, p<0.01 and R=0.48, p<0.01 respectively), RV end-systolic area (R=-0.63, p<0.001 and R=-0.48, p<0.01 respectively), RV end-diastolic area: R=-0.58, p<0.001 and R=-0.41, p=0.03 respectively), and RV glucose uptake by PET (R=-0.46, p=0.01 and R=-0.30, p=0.10 respectively). NT-proBNP was negatively correlated with TC (R=-0.61, p=0.01) and TG (R=-0.62, p<0.02) in PH.
UNASSIGNED: These findings confirm dyslipidemia is associated with worse right ventricular function in PH.