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Serum Oxysterol Levels in Heart Failure With Preserved Ejection Fraction: A Prospective Case-Control Study
Musa Dagli1, Murat Kerkütlüoğlu2, Filiz Alkan Baylan3
1Cardiology, Akşehir Devlet Hastanesi, Konya, TUR.
Cureus
|October 24, 2025
Summary
Serum oxysterol levels are significantly higher in patients with heart failure with preserved ejection fraction (HFpEF). These findings suggest oxysterols may be novel biomarkers for HFpEF, reflecting disease mechanisms.
Area of Science:
- Cardiology
- Biochemistry
- Biomarker Discovery
Background:
- Heart failure with preserved ejection fraction (HFpEF) is a growing clinical challenge with limited treatment options.
- Oxysterols, cholesterol oxidation products, are implicated in cardiovascular diseases but their role in HFpEF is unknown.
Purpose of the Study:
- To investigate the association between serum oxysterol levels and HFpEF.
- To explore oxysterols as potential novel biomarkers for HFpEF.
Main Methods:
- Prospective study of 101 participants (51 HFpEF patients, 50 controls).
- Serum oxysterols (7-ketocholesterol, 25-hydroxycholesterol, 7α,25-dihydroxycholesterol) measured by LC/MS.
- Correlations analyzed with clinical, biochemical (NT-proBNP), and echocardiographic data.
Main Results:
- HFpEF patients showed significantly higher serum levels of all measured oxysterols compared to controls (p < 0.001).
- Oxysterol levels strongly correlated with NT-proBNP (r=0.630-0.778, p < 0.001).
- Weak correlations observed with BMI and left atrial diameter; no association with comorbidities.
Conclusions:
- This study first demonstrates elevated serum oxysterols in HFpEF patients.
- Oxysterols correlate with NT-proBNP, suggesting potential as HFpEF biomarkers.
- Further multicenter studies are needed to confirm findings and prognostic value.
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