Galatius Emilie S, Lassen Mats C Højbjerg, Skaarup Kristoffer Grundtvig, Johansen Niklas Dyrby, Galatius Søren, Jensen Gorm Boje, Schnohr Peter, Møgelvang Rasmus, Biering-Sørensen Tor
Department of Cardiology, Copenhagen University Hospital - Herlev & Gentofte, Copenhagen, Denmark.
Department of Cardiology, Copenhagen University Hospital - Frederiksberg & Bispebjerg, Copenhagen, Denmark.
Echocardiography. 2025 Jul;42(7):e70249. doi: 10.1111/echo.70249.
A causal relationship between ischemic heart disease and cholesterol remnants (CR) has been suggested by genetic studies. We studied whether CR are associated with alterations in cardiac structure and function, as evaluated by sensitive echocardiographic measures in individuals without known heart disease.
All participants from the 5th Copenhagen City Heart Study without known heart disease underwent a comprehensive echocardiography including two-dimensional speckle tracking analysis. CR levels were calculated from lipid analyses in non-fasting venous blood samples.
The study included 3792 participants. Mean age was 55 years and 42% were male. In multivariable analyses adjusted for age, sex, body mass index, hypertension, diabetes and smoking status, increasing levels of CR were significantly associated with alterations in cardiac function, demonstrated as decreasing left ventricular ejection fraction (stand. β-coef. = -0.060, p = 0.001), a decreasing global longitudinal strain (stand. β-coef. = -0.045, p = 0.014), and a decreasing E/A ratio (stand. β-coef. = -0.110, p < 0.001). This association was significantly stronger than the association with cardiac alterations and LDL levels. Additionally, increasing levels of CR were associated with alterations in cardiac structure in the univariable analysis, but these associations were attenuated after multivariable adjustment.
In a general population sample without known heart disease both impaired systolic and diastolic function were present with increasing levels of CR. This association was stronger than the association between cardiac alterations and LDL-cholesterol levels. The findings support the need for additional research in the potential effect of CR on cardiac health.
This study investigates the association between cholesterol remnants and cardiac structure and function in 3792 individuals without known heart disease. Utilizing sensitive echocardiographic measures, we observed a significant association between increasing cholesterol remnant levels and compromised cardiac function, including reduced left ventricular ejection fraction, global longitudinal strain, and E/A ratio. This association surpassed that of LDL levels. In contrast, cholesterol remnants exhibited an association with cardiac structure only in univariable analysis. The findings support the need for further research into the potential long-term effects of and interventions focused on remnant cholesterol in healthy individuals.
基因研究提示缺血性心脏病与胆固醇残粒（CR）之间存在因果关系。我们研究了在无已知心脏病的个体中，通过敏感的超声心动图测量评估，CR是否与心脏结构和功能的改变相关。
来自第五届哥本哈根城市心脏研究的所有无已知心脏病的参与者均接受了包括二维斑点追踪分析在内的全面超声心动图检查。CR水平通过非空腹静脉血样本的脂质分析计算得出。
该研究纳入了3792名参与者。平均年龄为55岁，42%为男性。在对年龄、性别、体重指数、高血压、糖尿病和吸烟状况进行调整的多变量分析中，CR水平升高与心脏功能改变显著相关，表现为左心室射血分数降低（标准β系数=-0.060，p=0.001）、整体纵向应变降低（标准β系数=-0.045，p=0.014）以及E/A比值降低（标准β系数=-0.110，p<0.001）。这种关联明显强于与心脏改变和低密度脂蛋白水平的关联。此外，在单变量分析中，CR水平升高与心脏结构改变相关，但在多变量调整后这些关联减弱。
在无已知心脏病的一般人群样本中，随着CR水平升高，收缩和舒张功能均受损。这种关联强于心脏改变与低密度脂蛋白胆固醇水平之间的关联。这些发现支持有必要对CR对心脏健康的潜在影响进行更多研究。
本研究调查了3792名无已知心脏病个体中胆固醇残粒与心脏结构和功能之间的关联。利用敏感的超声心动图测量方法，我们观察到胆固醇残粒水平升高与心脏功能受损之间存在显著关联，包括左心室射血分数、整体纵向应变和E/A比值降低。这种关联超过了低密度脂蛋白水平。相比之下，胆固醇残粒仅在单变量分析中与心脏结构相关。这些发现支持有必要进一步研究健康个体中残余胆固醇的潜在长期影响以及针对残余胆固醇的干预措施。
