Association Between Cholesterol Remnants and Cardiac Structure and Function: The Copenhagen City Heart Study

Area of Science:

• Cardiology
• Lipid Metabolism
• Echocardiography

Background:

• Genetic studies suggest a link between ischemic heart disease and cholesterol remnants (CR).
• Previous research has not fully elucidated the impact of CR on cardiac structure and function in the general population without known heart disease.

Purpose of the Study:

• To investigate the association between cholesterol remnants (CR) and cardiac structure and function.
• To evaluate these associations using sensitive echocardiographic measures in individuals without known heart disease.

Main Methods:

• A comprehensive echocardiography, including two-dimensional speckle tracking analysis, was performed on 3792 participants from the 5th Copenhagen City Heart Study.
• Cholesterol remnant (CR) levels were quantified from non-fasting venous blood lipid analyses.
• Multivariable analyses were conducted, adjusting for age, sex, body mass index, hypertension, diabetes, and smoking status.

Main Results:

• Increasing levels of cholesterol remnants (CR) were significantly associated with impaired cardiac function, including reduced left ventricular ejection fraction, global longitudinal strain, and E/A ratio.
• The association between CR and cardiac function was stronger than that observed with LDL cholesterol levels.
• While CR showed associations with cardiac structure in univariable analysis, these were attenuated after multivariable adjustment.

Conclusions:

• In a general population sample without known heart disease, elevated cholesterol remnants (CR) are associated with both impaired systolic and diastolic cardiac function.
• These findings highlight the potential detrimental role of CR in cardiac health, independent of LDL cholesterol.
• Further research is warranted to explore the long-term effects of CR on cardiac health and potential interventions.