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HDL-C to hsCRP ratio is associated with left ventricular diastolic function in absence of significant coronary
Lufan Sun1, Xiaorui Liu2,3, Wenna Li2
1Department of Cardiology, The First Hospital of China Medical University, 155 North Nanjing Street, Shenyang, 110001, China. sunlf02@outlook.com.
Insights
The ratio of high-density lipoprotein cholesterol (HDL-C) to high-sensitive C-reactive protein (hsCRP) is linked to left ventricular (LV) diastolic function. A lower HDL-C/hsCRP ratio indicates a higher risk of LV diastolic dysfunction, even without significant coronary atherosclerosis.
Area of Science:
- Cardiology
- Biochemistry
- Internal Medicine
Background:
- High-density lipoprotein cholesterol (HDL-C) is a known protective marker against coronary atherosclerotic disease (CAD).
- The association between HDL-C and left ventricular (LV) diastolic function, particularly in relation to inflammation and in the absence of significant coronary atherosclerosis, remains unclear.
Purpose of the Study:
- To investigate the relationship between the HDL-C/hsCRP ratio and LV diastolic function.
- To determine if this ratio is associated with LV diastolic dysfunction in patients suspected of CAD but without significant coronary atherosclerosis.
Main Methods:
- 392 patients with suspected CAD and chest pain were enrolled.
- Coronary angiography/CT and echocardiography were used to assess coronary atherosclerosis and LV function.
- Plasma HDL-C and high-sensitive C-reactive protein (hsCRP) levels were measured to calculate the HDL-C/hsCRP ratio.
Main Results:
- 204 patients without significant coronary atherosclerosis were analyzed.
- The HDL-C/hsCRP ratio strongly correlated with LV diastolic function (E/e'), with higher ratios indicating better function.
- A lower HDL-C/hsCRP ratio was identified as a protective factor against LV diastolic dysfunction.
Conclusions:
- The HDL-C/hsCRP ratio is a significant correlate of LV diastolic function in individuals without significant coronary atherosclerosis.
- A low HDL-C/hsCRP ratio is associated with an increased risk of LV diastolic dysfunction, suggesting its role in subclinical cardiovascular changes.
Background:
High-density lipoprotein cholesterol (HDL-C) is considered as a protective marker of coronary atherosclerotic disease (CAD). It is still not clear if HDL-C is associated with left ventricular (LV) diastolic function in an inflammation-related manner in absence of significant coronary atherosclerosis.
Methods:
392 patients who complained of chest pain and were suspected of CAD without heart failure were enrolled in this study. Coronary angiography or coronary artery CT scan was performed to detect coronary atherosclerosis. Transthoracic echocardiography was performed to evaluate cardiac function. Plasma level of HDL-C and high-sensitive C-reactive protein (hsCRP) were determined in each subject. Relationship between HDL-C/hsCRP ratio and LV diastolic function in subjects without significant coronary atherosclerosis was investigated.
Results:
204 subjects without significant coronary plaques were analyzed finally, including 84 males and 120 females whose ages ranged from 30 to 84 years old. When divided into HDL-C/hsCRP quartiles, those in the fourth quartile demonstrated the best diastolic function (E/e' 10.14 ± 2.87, P = 0.02 ). HDL-C/hsCRP was the most significant factor correlated with E/e' in univariate regression analysis (r = - 0.232, P < 0.001) and multiple regression analysis adjusted by other factors (standardized β = - 0.258 , P < 0.0005 ). In logistic regression, HDL-C/hsCRP was proved to be a protective factor of LV diastolic dysfunction E/e' > 14 (OR = 0.649, 95%CI 0.444-0.948,P = 0.025 ). The sensitivity and specificity of using HDL-C/hsCRP < 0.98 to predict LV diastolic dysfunction were 64.3% and 56.2%, respectively. HDL-C/hsCRP ratio presented a reduced trend as increasing rate of CV risk factors.
Conclusions:
HDL-C/hsCRP ratio strongly correlates with LV diastolic function in absence of significant coronary atherosclerosis. Low HDL-C/hsCRP ratio tends to relate with LV diastolic dysfunction.
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