Rietzschel Ernst R, Langlois Michel, De Buyzere Marc L, Segers Patrick, De Bacquer Dirk, Bekaert Sofie, Cooman Luc, Van Oostveldt Patrick, Verdonck Pascal, De Backer Guy G, Gillebert Thierry C
Department of Cardiovascular Diseases, Ghent University, Ghent, Belgium.
Hypertension. 2008 Sep;52(3):535-41. doi: 10.1161/HYPERTENSIONAHA.108.114439. Epub 2008 Jul 28.
In contrast to the plethora of vasculopathies to which oxidized low-density lipoprotein cholesterol (ox-LDL) can be linked, there are no data linking ox-LDL to myocardial (dys)function in the community. We tested whether ox-LDL, a marker of oxidative stress, was linked to early cardiac structural and functional damage in the general population. The Asklepios Study is a random sample of 2524 male and female volunteers, comparable to the Belgian population between 35 and 55 years free from overt cardiovascular disease. Cardiac morphology, systolic, and early and late diastolic tissue Doppler mitral annulus velocities were recorded during an echocardiography, followed by a vascular examination (carotid and femoral arteries). Serum ox-LDL was measured by sandwich ELISA using the mAb-4E6 monoclonal antibody. Effects of ox-LDL were assessed after adjustment for age, gender, lipid fractions, blood pressure, heart rate, height, weight, glycemia, smoking, and drug treatment. Mean ox-LDL was 96.0+/-38.9 U/L. After adjustment, increasing ox-LDL levels were associated with a more spherical left ventricular cavity (minor/major axis dimensions; P<0.001) and decreasing diastolic (early diastolic tissue Doppler mitral annulus velocity; P<0.001, more pronounced in women) and systolic function (amplitude of systolic tissue Doppler mitral annulus velocity; P=0.008, more pronounced in men). These results remained unaffected when further adjustments were made for inflammatory markers, lifestyle, or vascular damage (atherosclerosis and arterial stiffening). These results are the first "proof of concept" that ox-LDL impacts cardiac structure and function at a community level, independent of classic risk factors, lifestyle, inflammation, and prevalent vascular damage. Our data suggest that ox-LDL is a risk marker for early ventricular remodelling. However, the effect size in the general population is small.
与氧化型低密度脂蛋白胆固醇（ox-LDL）可能关联的众多血管病变不同，在普通人群中，尚无数据表明ox-LDL与心肌（功能）异常有关。我们测试了氧化应激标志物ox-LDL是否与普通人群早期心脏结构和功能损害有关。阿斯克勒庇俄斯研究是对2524名男性和女性志愿者的随机抽样，这些志愿者与比利时35至55岁无明显心血管疾病的人群特征相似。在超声心动图检查期间记录心脏形态、收缩功能以及舒张早期和晚期的组织多普勒二尖瓣环速度，随后进行血管检查（颈动脉和股动脉）。使用单克隆抗体mAb-4E6通过夹心ELISA法测定血清ox-LDL。在对年龄、性别、血脂成分、血压、心率、身高、体重、血糖、吸烟和药物治疗进行校正后，评估ox-LDL的影响。ox-LDL的平均水平为96.0±38.9 U/L。校正后，ox-LDL水平升高与左心室腔更呈球形（短轴/长轴尺寸；P<0.001）以及舒张功能降低（舒张早期组织多普勒二尖瓣环速度；P<0.001，在女性中更明显）和收缩功能降低（收缩期组织多普勒二尖瓣环速度幅度；P=0.008，在男性中更明显）相关。当对炎症标志物、生活方式或血管损伤（动脉粥样硬化和动脉僵硬度）进行进一步校正时，这些结果不受影响。这些结果是首个“概念验证”，表明ox-LDL在社区层面影响心脏结构和功能，独立于经典危险因素、生活方式、炎症和普遍存在的血管损伤。我们的数据表明ox-LDL是早期心室重构的风险标志物。然而，在普通人群中的效应大小较小。
