Document Detail


The effects of dyslipidemia on left ventricular systolic function in patients with stable angina pectoris.
MedLine Citation:
PMID:  10487494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Large-scale clinical trials have shown that long-term treatment with lipid-lowering therapy results in a significant reduction in the occurrence of heart failure among patients with coronary artery disease without previous evidence of congestive heart failure, suggesting dyslipidemia may have an adverse effect on left ventricular performance. To examine whether dyslipidemia has a detrimental effect on left ventricular systolic function and whether this effect is dependent on the corresponding severity of coronary atherosclerosis, 114 consecutive patients with stable angina and a positive exercise thallium-201 myocardial perfusion single-photon emission computed tomography were studied. All patients underwent measurement of serum lipid profiles, right-sided heart catheterization, left ventriculography, and selective coronary arteriography. Mean serum levels of total cholesterol and triglycerides were 4.5 and 1.4 mmol/l, respectively. In univariate analysis, a significant positive correlation between serum high-density lipoprotein (HDL) cholesterol and left ventricular ejection fraction (LVEF) (r = 0.49, P<0.0001) was found. Patients in the lower tertile of serum HDL cholesterol had a significantly lower mean LVEF than those in the upper tertile (55.9+/-15.2 vs. 72.8+/-6.8%, P<0.0001). Stepwise multiple linear regression analysis revealed that LVEF significantly correlated with HDL cholesterol (P<0.0001), the Gensini score (P = 0.008), and diabetes mellitus (P = 0.08) (r = 0.55, P<0.0001). In subgroup analysis of patients with angiographically normal coronary arteries, serum HDL cholesterol was still significantly associated with LVEF. The present study demonstrated an independent association between low HDL cholesterol and subclinical left ventricular systolic dysfunction in Chinese patients with stable angina whose serum levels of total cholesterol and triglycerides were relatively low. Moreover, this correlation remained significant even in patients with normal coronary angiograms, suggesting HDL cholesterol might influence left ventricular systolic performance through extra-atherosclerotic mechanisms.
Authors:
T D Wang; C M Lee; C C Wu; T M Lee; W J Chen; M F Chen; C S Liau; F C Sung; Y T Lee
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Atherosclerosis     Volume:  146     ISSN:  0021-9150     ISO Abbreviation:  Atherosclerosis     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-28     Completed Date:  1999-10-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0242543     Medline TA:  Atherosclerosis     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  117-24     Citation Subset:  IM    
Affiliation:
Section of Cardiology, Department of Internal Medicine, En Chu Kong Hospital, Taipei Hsien, Taiwan, ROC. jendougl@ms8.hinet.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Angina Pectoris / complications*,  diagnosis
Coronary Artery Disease / diagnosis,  etiology*,  physiopathology
Enzyme-Linked Immunosorbent Assay
Female
Heart Catheterization
Humans
Hyperlipidemias / complications*,  physiopathology*
Linear Models
Lipoproteins, HDL / blood*
Male
Middle Aged
Prospective Studies
Risk Assessment
Severity of Illness Index
Stroke Volume
Systole
Taiwan
Ventricular Function, Left*
Chemical
Reg. No./Substance:
0/Lipoproteins, HDL

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