Division of Cardiology, Department of Medicine of David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Am J Cardiol. 2013 Dec 1;112(11):1770-7. doi: 10.1016/j.amjcard.2013.07.045. Epub 2013 Sep 16.
Oxidative stress and inflammation are hallmarks of the heart failure (HF) disease state. In the present study, we investigated the inflammatory/anti-inflammatory characteristics of high-density lipoproteins (HDL) in patients with HF. Ninety-six consecutive patients with systolic HF were followed in an advanced HF center, and 21 healthy subjects were recruited. Plasma was tested for HDL inflammatory index (HII) using a monocyte chemotactic activity assay, with HII >1.0 indicating proinflammatory HDL. We found significantly increased inflammatory properties of HDL in patients with HF (median HII 1.56 vs 0.59 in controls; p <0.0001). Serum amyloid A level was markedly elevated and the activity of paraoxonase-1, an HDL antioxidant enzyme, was significantly reduced in patients versus controls. HDL and albumin from patients with HF contained markedly elevated levels of oxidized products of arachidonic and linoleic acids. HDL function improved when plasma was treated in vitro with 4F, an apolipoprotein A-I mimetic peptide (40% reduction in HII, p <0.0001). There was no correlation found between HII level and ejection fraction or New York Heart Association functional class. In conclusion, HDL function is significantly impaired and oxidation products of arachidonic and linoleic acids are markedly elevated in patients with HF compared with non-HF controls.
氧化应激和炎症是心力衰竭（HF）疾病状态的特征。在本研究中，我们研究了心力衰竭患者高密度脂蛋白（HDL）的炎症/抗炎特性。96 例收缩性 HF 患者在先进的 HF 中心进行了随访，招募了 21 名健康受试者。使用单核细胞趋化活性测定法检测血浆中的高密度脂蛋白炎症指数（HII），HII＞1.0 表示促炎 HDL。我们发现 HF 患者的 HDL 具有明显增加的炎症特性（中位数 HII 为 1.56，对照组为 0.59；p＜0.0001）。血清淀粉样蛋白 A 水平显著升高，HDL 抗氧化酶对氧磷酶-1 的活性在患者与对照组之间显著降低。HF 患者的 HDL 和白蛋白中含有明显升高的花生四烯酸和亚油酸氧化产物。当用载脂蛋白 A-I 模拟肽 4F 体外处理血浆时，HDL 功能得到改善（HII 降低 40%，p＜0.0001）。HII 水平与射血分数或纽约心脏协会功能分级之间没有相关性。总之，与非 HF 对照组相比，HF 患者的 HDL 功能明显受损，花生四烯酸和亚油酸的氧化产物明显升高。
