[Behavior of HDL cholesterol and the apoproteins A1 A2 and B in the central circulation in patients with coronary disease and genetically determined hyperlipoproteinemias].

Seven lipid parameters, including apoproteins A1, A2 and B were determined in blood from different parts of the cardiovascular system in two groups of patients one with and the other without coronary heart disease. In addition, HDL cholesterol levels were compared in patients with coronary heart disease and primary monogenic combined hyperlipoproteinaemia. None of the seven parameters showed significant differences in samples from the pulmonary artery (mixed venous blood) and the hepatic vein of the control and patient groups. The expected significant concentration gradient between the two vascular regions was confirmed in the groups with and without coronary heart disease. HDL components showed a contrary behaviour: the hepatic vein and pulmonary artery exhibited significantly lower values of HDL cholesterol in patients with coronary heart disease than in the controls, but this was not true for HDL apoproteins A1 and A2. Patients with coronary heart disease and primary hyperlipoproteinaemia showed a significant concentration gradient between the two vascular regions for total and HDL cholesterol. These observations reveal the importance of genetic disturbances of lipid metabolism, particularly the implication of various lipid fractions in the pathogenesis of atherosclerosis.