Decreased Serum Lipoprotein Levels as a Guide for Clinical Severity in Patients with Idiopathic Dilated Cardiomyopathy

Abstract

Hyperlipidemia is a cardiovascular risk factor. In patients with idiopathic dilated cardiomyopathy (IDC), prognostic roles of endogenous lipoproteins are not fully clarified. It has been known that there is a direct relationship between the levels of cytokines (tumor necrosis factor-α [TNF-α ] and interleukin-6 [IL-6]) and deteriorating functional classes of heart failure and mortality. The present study compared the levels of circulating TNF-α , IL-6, lipoproteins, and apolipoproteins in patients with stable IDC (n = 28) with those of patients with unstable IDC (n = 26) and controls (n = 24). Mean serum total cholesterol (TC) was significantly lower in stable IDC patients than controls (p < 0.05). In unstable IDC patients, mean serum TC was also lower than controls but not statistically significant. The IDC patients had significantly higher concentrations of IL-6 and TNF-α than the controls (p < 0.01). Serum IL-6 and Apo AI levels were significantly different between stable and unstable IDC patients (p = 0.021 and p = 0.012, respectively). Increased levels of IL-6 were associated with decreased levels of TC (r = −0.266, p = 0.019), LDL-C (r = −0.376, p = 0.001) and apolipoprotein AI (apo AI) (r = −0.495, p < 0.001) in all IDC patients. TNF-α was also inversely related to apo AI (r = −0.455, p < 0.001) and LDL-C (r = −0.364, p = 0.001) in all patients. Thus, elevated serum levels of cytokines in patients with IDC are associated with decreased lipoprotein concentrations, which may indicate impaired prognosis. heart failure; lipoprotein; apolipoprotein; cytokine

Elevated serum uric acid levels impair coronary microvascular function in patients with idiopathic dilated cardiomyopathy

“…We have found that patients with impaired CFR have lower total cholesterol, LDL cholesterol, and triglyceride values in accordance with a study by Sezgin et al [12], which reported that decreased lipoprotein concentrations in patients with IDC indicate poorer prognosis.…”

Serum proteome profiling in canine idiopathic dilated cardiomyopathy using TMT-based quantitative proteomics approach

“…Apolipoproteins A1 (APOA1), A4 (APOA4) and C3 (APOC3), which are lipid-binding proteins involved in the transport of lipids in plasma, were found to be down-regulated in iDCM compared to control serum in our study. Lower plasma APOA1 levels were also found in human patients with iDCM compared to controls [29,33]. APOA1 is a major constituent of high-density lipoprotein particles which was found to have anti-inflammatory properties since it may interfere with the assembly of complement C9 of the MAC of complement cascade [34].…”

Diminished Antioxidant Activity of High-Density Lipoprotein–Associated Proteins in Systolic Heart Failure

“…In patients with established heart failure, the role of low HDL and/or low apolipoprotein A1 in predicting heart failure events as well as mortality has been demonstrated17-20, even in those with non-ischemic etiologies21. While most have speculated the primary contribution of HDL’s favorable effects is via its reverse cholesterol transport properties, other anti-inflammatory, anti-apoptotic, and anti-thrombotic effects of HDL can also play important roles as evidenced by with its inverse relationship with inflammatory mediators22, 23.…”