Liu Yan, Hao Zirui, Xiao Chun, Liu Ling, Liao Huocheng
Department of Cardiology, The Third People's Hospital of Huizhou, Huizhou, Guangdong Province, China.
Arch Med Sci. 2018 Aug;14(5):988-994. doi: 10.5114/aoms.2017.70660. Epub 2017 Oct 12.
The aim was to evaluate the association of serum total cholesterol (TC) level and left ventricular ejection fraction (LVEF) in patients with heart failure (HF) caused by coronary heart disease (CHD).
A total of 236 participants were enrolled. Participants were divided into severely reduced (≤ 35%) and moderately reduced (> 35%) LVEF groups and the between-group difference was evaluated. Multivariate regression analysis was used to evaluate the association between LVEF and parameters of interest. Linear regression analysis was applied to analyze the odds ratio of per 1-SD increase in serum TC level for LVEF change.
Mean age was 57.3 years and males accounted for 58.1%. Mean serum TC level was 4.6 mmol/l, albumin (ALB) 33.6 g/l, and C-reactive protein (CRP) 11.4 mg/l. Mean LVEF was 38.3%. Compared to high-reduced LVEF group, participants in moderate-reduced LVEF group had significantly higher TC (4.8 ±0.9 mmol/l vs. 4.4 ± 0.7 mmol/l) and ALB (35.8 ±6.7 g/l vs. 31.4 ±6.0 g/l) but lower CRP (9.6 ±4.7 mg/l vs. 14.2 ±7.0 mg/l) levels ( < 0.05 for all comparisons). Increased TC and ALB levels were associated with higher LVEF, and increased CRP level was associated with lower LVEF. After adjusted for CRP, although per 1-SD increase in TC level was still associated with an increment in 4 % in LVEF, it did not achieve achieve statistic significance.
In patients with HF caused by CHD, higher serum TC level appeared to be associated with higher LVEF, which might be associated with systemic inflammation improvement.
目的是评估冠心病(CHD)所致心力衰竭(HF)患者血清总胆固醇(TC)水平与左心室射血分数(LVEF)之间的关联。
共纳入236名参与者。参与者被分为LVEF严重降低(≤35%)组和中度降低(>35%)组,并评估组间差异。采用多因素回归分析评估LVEF与感兴趣参数之间的关联。应用线性回归分析来分析血清TC水平每升高1个标准差时LVEF变化的比值比。
平均年龄为57.3岁,男性占58.1%。平均血清TC水平为4.6 mmol/l,白蛋白(ALB)为33.6 g/l,C反应蛋白(CRP)为11.4 mg/l。平均LVEF为38.3%。与LVEF高度降低组相比,LVEF中度降低组的参与者TC(4.8±0.9 mmol/l对4.4±0.7 mmol/l)和ALB(35.8±6.7 g/l对31.4±6.0 g/l)水平显著更高,但CRP(9.6±4.7 mg/l对14.2±7.0 mg/l)水平更低(所有比较P<0.05)。TC和ALB水平升高与较高的LVEF相关,而CRP水平升高与较低的LVEF相关。校正CRP后,尽管血清TC水平每升高1个标准差仍与LVEF增加4%相关,但未达到统计学显著性。
在冠心病所致心力衰竭患者中,较高的血清TC水平似乎与较高的LVEF相关,这可能与全身炎症改善有关。