scholarly journals Association Between the Lipid Profile and Renal Dysfunction in the Heart Failure Patients

2019 ◽  
Vol 44 (1) ◽  
pp. 52-61 ◽  
Author(s):  
Hong Zhang ◽  
Shuang Shi ◽  
Xiu-Juan Zhao ◽  
Jun-Kui Wang ◽  
Zhong-Wei Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Waist Circumference ◽  
Ejection Fraction ◽  
Lipid Profile ◽  
Renal Dysfunction ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Confounding Factors ◽  
Heart Failure Patients ◽  
Platelet Counts

Background/Aims: In heart failure patients with high prevalence of chronic renal disease (CKD), hospitalization and mortality, whether the lipid profile was associated with renal dysfunction remained unknown. The present study intended to clarify the association between the lipid profile and renal dysfunction in the heart failure patients. Methods: 336 hospitalized heart failure patients with left ventricle ejection fraction (LVEF) ≤45% and New York Heart Association (NYHA) class II-IV were enrolled. The estimated glomerular filtration rate (eGFR) < 90 mL/min·1.73 m2 was defined as renal dysfunction. The demographic, clinical data, blood samples and echocardiography were documented. The Pearson simple linear correlation was performed to evaluate the confounding factors correlated with eGFR. The significantly correlated factors were enrolled in Logistic regression as confounding factors to determine the association between the lipid profile and renal dysfunction in the heart failure patients. Results: 182 patients (54.2%) had renal dysfunction and 154 patients (45.8%) did not have renal dysfunction. The waist circumference, platelet counts, platelet distribution width (PDW), high density lipoprotein-cholesterol (HDL-C), apolipoprotein A1 (apoA1), albumin and left ventricular ejection fraction (LVEF) are positively correlated with eGFR (all P< 0.05). Meanwhile, the age, mean platelet volume (MPV), neutrophilic granulocyte percentage (NEUT%), urea nitrogen (BUN), creatinine and total bilirubin (TBIL) are negatively correlated with eGFR (all P< 0.05). The total cholesterol (TC), triglyceride, low density lipoprotein-cholesterol (LDL-C) and apolipoprotein B (apoB) show no correlation with eGFR. After the adjustment of sex, hypertension, diabetes mellitus, age, waist circumference, platelet counts, MPV, PDW, NEUT%, TBIL, albumin and LVEF, HDL-C is the only lipid factor still significantly associated with renal dysfunction in hospitalized heart failure patients (OR=0.119, P=0.003). Conclusion: Among the lipid profile of TC, triglyceride, LDL-C, HDL-C, apo A1 and apo B, the HDL-C is the only lipid factor significantly associated with renal dysfunction in hospitalized heart failure patients.

Clinical characteristics and prognostic influence of renal dysfunction in heart failure patients with preserved ejection fraction

2013 ◽  
Vol 24 (7) ◽  
pp. 677-683 ◽  
Author(s):  
Jesús Casado ◽  
Manuel Montero ◽  
Francesc Formiga ◽  
Margarita Carrera ◽  
Agustín Urrutia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Renal Dysfunction ◽  
Clinical Characteristics ◽  
Preserved Ejection Fraction ◽  
Heart Failure Patients

scholarly journals Effects of Sacubitril/Valsartan on Serum Lipids in Heart Failure with Preserved Ejection Fraction

2021 ◽  
Author(s):  
Senthil Selvaraj ◽  
Brian L. Claggett ◽  
Milton Packer ◽  
Faiez Zannad ◽  
Inder S. Anand ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Serum Lipids ◽  
Treatment Effects ◽  
Density Lipoprotein ◽  
Underlying Mechanism ◽  
Guanosine Monophosphate ◽  
Lipoprotein Cholesterol ◽  
Preserved Ejection Fraction ◽  
Lipid Levels

Abstract Background Dyslipidemia is common in heart failure with preserved ejection fraction (HFpEF). Sacubitril/valsartan improves insulin sensitivity and augments natriuretic peptide (NP) signaling, providing mechanisms by which sacubitril/valsartan may affect serum lipids. However, empiric data on these effects are lacking. Methods and Results We analyzed 4,744 participants from PARAGON‐HF with available screening lipids. During follow‐up visits, we analyzed the treatment effect on lipid levels and assessed for interaction by baseline lipid levels. At the 16‐week visit, we adjusted these treatment effects for the change in several biomarkers (including hemoglobin A1c and urinary cyclic guanosine monophosphate (cGMP)/creatinine [a biomarker of NP activation]). The average age was 73±8 years, 52% were women, 43% had diabetes mellitus, and 64% were on statin therapy. Compared with valsartan, sacubitril/valsartan reduced triglycerides ‐5.0% (‐6.6%, ‐3.5%), increased high‐density lipoprotein cholesterol (HDL‐c) +2.6% (+1.7%, +3.4%), and increased low‐density lipoprotein cholesterol (LDL‐c) +1.7% (+0.4%, +3.0%). Sacubitril/valsartan reduced triglycerides most among those with elevated baseline levels (triglycerides≥200 mg/dL) (p‐interaction<0.001), and at 16‐weeks by ‐13.0% (‐18.1%, ‐7.6%), or ‐29.9 (‐44.3, ‐15.5) mg/dL, in this group. Adjusting for the change in urinary cGMP/creatinine significantly attenuated treatment effects on triglycerides and HDL‐c, but not LDL‐c, while adjusting for other biomarkers did not significantly alter the treatment effects. Conclusions Sacubitril/valsartan significantly reduces triglycerides compared with valsartan, an effect that was substantially stronger in those with elevated baseline triglycerides. Modest increases in HDL‐c and LDL‐c cholesterol were also observed with therapy. The underlying mechanism(s) of changes in HDL‐c and triglycerides are related to sacubitril/valsartan’s effects on NP activity.

P3106Atrial fibrillation is not associated with the responses to exercise training in heart failure patients with preserved ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Hamazaki ◽  
T Masuda ◽  
K Kamiya ◽  
R Matsuzawa ◽  
K Nozaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Training ◽  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Muscle Function ◽  
Exercise Tolerance ◽  
Clinical Characteristics ◽  
Confounding Factors ◽  
Heart Failure Patients ◽  
Peripheral Muscle

Abstract Background Atrial fibrillation (AF) is known as a common arrhythmia in heart failure patients with preserved left ventricular ejection fraction (HFpEF). Several studies have reported that HFpEF patients with AF show lower exercise tolerance and poorer prognosis as compared with those with sinus rhythm (SR). On the other hand, exercise training is documented to improve peripheral muscle function and exercise tolerance in HFpEF patients. However, the relationship between AF status and outcomes due to exercise training is still unclear in these patients. Purpose We aimed to investigate the influence of AF on the responses to outcomes with exercise training in HFpEF patients. Methods We studied 426 patients with HFpEF who received 5-month cardiac rehabilitation including exercise training during hospitalization and after hospital discharge. As clinical characteristics, we obtained body mass index, disease aetiology, comorbidity conditions, blood examination and echocardiographic variables from medical records. We also measured isometric quadriceps strength (QS) and 6-minute walk distance (6MWD) as peripheral muscle strength and exercise tolerance, respectively. The QS and 6MWD were assessed at hospital discharge as the baseline and 5 months later. AF status was determined by the presence on electrocardiogram at baseline 6MWD or medical history of AF during hospitalization. In statistical analysis, we compared baseline clinical characteristics, QS and 6MWD between the rhythm status (SR group or AF group). We also examined the changes in QS and 6MWD from baseline to the 5-month observation period (ΔQS and Δ6MWD) and compared them between the 2 groups using analysis of covariance with adjustment for baseline clinical confounding factors. Results At baseline, 289 patients (68%) were in SR, and 111 patients (26%) had AF. The AF was associated significantly with older age (P<0.001) and lower levels of estimated glomerular filtration rate (P=0.013), QS (P<0.001) and 6MWD (P<0.001) at baseline. The QS increased significantly from 25.2±11.0 kg at baseline to 30.8±13.0 kg after 5-month cardiac rehabilitation in the SR group, and from 21.1±8.3 kg to 26.0±9.4 kg in the AF group (P<0.001, respectively). The 6MWD also increased significantly from 394.8±129.2 to 463.5±133.5 meters in the SR, and from 343.7±107.9 to 403.0±114.5 meters in the AF (P<0.001, respectively). There were no significant differences in ΔQS and Δ6MWD between the SR and AF groups even after adjustment for clinical confounding factors including baseline QS or 6MWD (Figure). Conclusions The AF status in HFpEF patients was associated with older age, lower peripheral muscle function and also lower exercise tolerance at baseline, but not associated with the responses to exercise training. Acknowledgement/Funding JSPS KAKENHI JP16K16442

scholarly journals Waist circumference and low high-density lipoprotein cholesterol as markers of cardiometabolic risk in Kenyan adults

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247600
Author(s):  
Daniel Faurholt-Jepsen ◽  
Henrik Friis ◽  
David L. Mwaniki ◽  
Michael K. Boit ◽  
Lydia U. Kaduka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Waist Circumference ◽  
High Density Lipoprotein ◽  
Lipid Profile ◽  
Hepatic Steatosis ◽  
Cardiometabolic Risk ◽  
Density Lipoprotein ◽  
High Density ◽  
Cardiometabolic Risk Factors ◽  
Lipoprotein Cholesterol

Background Abdominal obesity predict metabolic syndrome parameters at low levels of waist circumference (WC) in Africans. At the same time, the African lipid profile phenotype of low high-density lipoprotein (HDL) cholesterol without concomitant elevated triglyceride levels renders high triglyceride levels detrimental to cardiometabolic health unsuitable for identifying cardiometabolic risk in black African populations. Objectives We aimed to identify simple clinical measures for cardiometabolic risk based on WC and HDL in an adult Kenyan population in order to determine which of the two predictors had the strongest impact. Methods We used linear regression analyses to assess the association between the two exposure variables WC and HDL with cardiometabolic risk factors including ultrasound-derived visceral (VAT) and subcutaneous adipose tissue (SAT) accumulation, fasting and 2-h venous glucose, fasting insulin, fasting lipid profile, and blood pressure in adult Kenyans (n = 1 370), and a sub-population with hyperglycaemia (diabetes and pre-diabetes) (n = 196). The same analyses were performed with an interaction between WC and HDL to address potential effect modification. Ultrasound-based, semi-quantitative hepatic steatosis assessment was used as a high-risk measure of cardiometabolic disease. Results Mean age was 38.2 (SD 10.7) (range 17–68) years, mean body mass index was 22.3 (SD 4.5) (range 13.0–44.8) kg/m2, and 57.8% were women. Cardiometabolic risk was found in the association between both WC and HDL and all outcome variables (p<0.05) except for HDL and SAT, fasting and 2-h venous glucose. Additive cardiometabolic risk (WC and HDL interaction) was found for SAT, low-density lipoprotein cholesterol, and triglycerides. No differences in the association between WC and HDL and the outcome variables were found when comparing the full study population and the hyperglycaemia sub-population. Increase in WC and HDL were both associated with hepatic steatosis (OR 1.09, p<0.001, and OR 0.46, p = 0.031, respectively). Conclusion In adult Kenyans, increasing WC identified more cardiometabolic risk factors compared to HDL.

Galectin-3 in Heart Failure – Linking Fibrosis, Remodelling and Progression

2010 ◽  
Vol 6 (2) ◽  
pp. 33 ◽  
Author(s):  
Christopher R deFilippi ◽  
G Michael Felker ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Risk Stratification ◽  
Cardiac Fibrosis ◽  
The Elderly ◽  
Preserved Ejection Fraction ◽  
Heart Failure Patients ◽  
Large Populations ◽  
Galectin 3

For many with heart failure, including the elderly and those with a preserved ejection fraction, both risk stratification and treatment are challenging. For these large populations and others there is increasing recognition of the role of cardiac fibrosis in the pathophysiology of heart failure. Galectin-3 is a novel biomarker of fibrosis and cardiac remodelling that represents an intriguing link between inflammation and fibrosis. In this article we review the biology of galectin-3, recent clinical research and its application in the management of heart failure patients.

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