Differential serum lipid distribution in IPAH and CHD-PAH patients

Chen, Jingyuan; Rathinasabapathy, Anandharajan; Luo, Jun; Yang, Xiaojie; Luo, Ping; Chen, Yu-Si; Li, Zilu; Jiang, Li

doi:10.1016/j.rmed.2021.106711

Cited by 8 publications

(8 citation statements)

References 51 publications

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“…In line with current results, several studies show no alteration in TG level in PH 18,21 . While not confirmed in our findings, other research studies have documented reduced levels of LDL-C, and TC, demonstrating their prognostic role in PH 6,17,18 . These variations might be attributed to differences in participants’ demographic and clinical characteristics.…”

Section: Discussioncontrasting

confidence: 97%

“…In the current study, individuals with PH exhibit a distinctive plasma lipid distribution characterized by lower HDL-C, and apo-AI and higher TG to HDL-C ratio. This observation aligns with findings reported in previous studies 6–8,17,18 . A reduced level of HDL-C is an important biomarker and correlates with disease severity and mortality in PH 6,18–21 .…”

Section: Discussionsupporting

confidence: 93%

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Blood Cholesterol and Triglycerides Associate with Right Ventricular Function in Pulmonary Hypertension

Fakhry,

Peterson,

Comhair

et al. 2024

Preprint

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Background: 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. Methods: 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. Results: 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. Conclusion: These findings confirm dyslipidemia is associated with worse right ventricular function in PH.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionsupporting

confidence: 93%

Blood Cholesterol and Triglycerides Associate with Right Ventricular Function in Pulmonary Hypertension

Fakhry,

Peterson,

Comhair

et al. 2024

Preprint

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“…Previous data showed that dyslipidemia is a major factor in the progression of CVD in SLE ( 36 ), but whether dyslipidemia is associated with PAH in patients with SLE remains unclear. Lipid homeostasis is dysregulated in patients with PH in which low HDL and LDL levels have been found ( 11 , 37 , 38 ); therefore, their anti-inflammatory properties may be relevant for predicting disease severity and prognosis in patients with PH, and the decreased HDL and LDL levels is also associated with the right heart function in patients with idiopathic PAH ( 39 ). Wang et al ( 13 ) found that the optimal cutoff value of the serum HDL concentration for predicting PAH was 1.32 mmol/l.…”

Section: Discussionmentioning

confidence: 99%

Decreased low‑density lipoprotein and the presence of pulmonary arterial hypertension among newly diagnosed drug‑naïve patients with systemic lupus erythematosus: D‑dimer as a mediator

Huang

Zhang

et al. 2022

Exp Ther Med

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Pulmonary arterial hypertension (PAH) is commonly associated with systemic lupus erythematosus (SLE). The present study investigated the relationship between coagulation and changes in lipid parameters in newly-diagnosed patients with SLE in the presence of PAH and whether the coagulation parameters were mediators between lipids and PAH presence. A total of 301 subjects scheduled for new-onset drug-naïve SLE were consecutively enrolled. Baseline data for patients without PAH and with PAH were gathered and compared. Coagulation and lipid parameters were compared across patients without lipid regulating and anticoagulation medications. Multivariable logistic regression model was applied to examine potential predictors of PAH in SLE. The relationships between them were examined using Spearman's correlation analysis. The relationship between coagulation index and lipids with SLE-PAH was evaluated using mediation analysis. Female patients accounted for 88.0% of the 301 subjects, and the average age was 32 years (range, 25-45 years). A total of 40 patients (13.3%) had PAH, and the average pulmonary artery systolic pressure (sPAP) was 55.825±26.67 mmHg. Patients with PAH were older and had higher levels of fibrin/fibrinogen degradation products (FDP), D-dimer, C-reactive protein, lower levels of complement 3, complement 4 and 25-hydroxy vitamin D3 compared with the non-PAH group. Multivariable logistic regression analysis showed that age and D-dimer were independent predictor factors for PAH. Among patients without lipid regulating and anticoagulation medications, patients in the PAH group had higher levels of D-dimer and FDP, and lower low-density lipoprotein (LDL) levels compared with patients without PAH. There was also a positive relationship between sPAP and D-dimer and FDP, and a negative relationship between sPAP and total cholesterol and LDL. Mediation analysis indicated that 25.61% of the effect of low LDL on PAH presence in systemic lupus erythematosus was mediated by D-dimer. Overall, the effect of low LDL on SLE-PAH appeared to be mediated by D-dimer, which mediated 25.61% of this effect.

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“…Therefore, serum total cholesterol may have a favorable effect in patients with heart failure, and lower total cholesterol levels may relate to worse prognoses in these patients, reflecting impaired nutritional and inflammatory conditions. Total cholesterol level was also reported to be lower in patients with pulmonary hypertension than in those without pulmonary hypertension, and lower total cholesterol was associated with worse prognosis in patients with PAH 52–54 . Although the pathological relationship between total cholesterol and PAH has not been fully clarified, lower total cholesterol levels may be associated with worse prognosis in patients with PAH, reflecting worse conditions of malnutrition and inflammation; this is similar to that observed in patients with heart failure.…”

Section: Discussionmentioning

confidence: 58%

Impact of malnutrition on prognosis in patients with pulmonary arterial hypertension

Nakashima,

Akagi,

Ejiri

et al. 2023

Pulm. circ.

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Pulmonary arterial hypertension is a life‐threatening disease that coexists with right heart failure. We evaluated the relationship between malnutrition and prognosis in patients with pulmonary arterial hypertension, as malnutrition is known as a prognosis determinant in chronic heart failure. We retrospectively reviewed data of patients with pulmonary arterial hypertension before treatment. The Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Controlling Nutritional Status scores on the day of diagnosis were calculated to assess the nutritional status. Clinical endpoints were defined as composite outcomes of all‐cause death or lung transplantation. Eighty patients were enrolled (mean age, 50 years; 23 men). The mean pulmonary arterial pressure was 47 ± 19 mmHg, Geriatric Nutritional Risk Index was 99.9 ± 12.0, and Prognostic Nutritional Index was 46.3 ± 10.0. The median Controlling Nutritional Status score was 2 (1–4). During the median 5.5‐year follow‐up period, 28 composite events occurred. Kaplan‐Meier analysis demonstrated significant differences in the incidence of clinical endpoints between groups divided by each median Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Controlling Nutritional Status score (p = 0.007, 0.039, and 0.010, respectively). In multivariate Cox regression analysis, clinical endpoints were significantly associated with Geriatric Nutritional Risk Index (hazard ratio: 0.953, 95% confidence interval: 0.918–0.990), Prognostic Nutritional Index (hazard ratio: 0.942, 95% confidence interval: 0.892–0.996), and Controlling Nutritional Status score (hazard ratio: 1.230, 95% confidence interval: 1.056–1.433) after adjustment for factors associated in univariate Cox regression analysis. Malnutrition at diagnosis is a useful prognostic predictor for patients with pulmonary arterial hypertension.

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Differential serum lipid distribution in IPAH and CHD-PAH patients

Cited by 8 publications

References 51 publications

Blood Cholesterol and Triglycerides Associate with Right Ventricular Function in Pulmonary Hypertension

Blood Cholesterol and Triglycerides Associate with Right Ventricular Function in Pulmonary Hypertension

Decreased low‑density lipoprotein and the presence of pulmonary arterial hypertension among newly diagnosed drug‑naïve patients with systemic lupus erythematosus: D‑dimer as a mediator

Impact of malnutrition on prognosis in patients with pulmonary arterial hypertension

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