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Published on: October 12, 2017
Elevated lipoprotein(a) levels are associated with adverse left ventricular geometric remodeling in non-diabetic
Tolga Kunak1, Ayşegül Ülgen Kunak2, İbrahim Başarici1
1Department of Cardiology, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
Insights
Elevated Lipoprotein(a) [Lp(a)] levels are linked to adverse left ventricular (LV) remodeling, specifically concentric hypertrophy, in hypertensive patients. Lp(a) assessment aids cardiovascular risk stratification.
Area of Science:
- Cardiology
- Hypertension Research
- Lipid Metabolism
Background:
- Lipoprotein(a) [Lp(a)] is a known cardiovascular risk factor.
- Its association with left ventricular (LV) geometric remodeling in hypertension is not well-defined.
- Essential hypertension and elevated Lp(a) are significant cardiovascular concerns.
Purpose of the Study:
- To investigate the association between serum Lp(a) levels and LV geometry.
- To examine LV remodeling patterns in non-diabetic patients with essential hypertension.
- To determine if Lp(a) is an independent predictor of LV geometric changes.
Main Methods:
- Cross-sectional observational study of 110 non-diabetic hypertensive patients.
- Patients grouped by low (<50 mg/dL) and elevated (≥50 mg/dL) Lp(a) levels.
- Echocardiography assessed LV mass index (LVMI) and geometry; regression analyses identified associations.
Main Results:
- Elevated Lp(a) group showed significantly higher LVMI (139.6 vs. 117.6 g/m², p<0.001).
- Concentric LV hypertrophy was more prevalent in the elevated Lp(a) group (55.0% vs. 20.0%, p=0.001).
- Lp(a) was independently associated with LVMI and odds of concentric LV hypertrophy.
Conclusions:
- Elevated serum Lp(a) is independently linked to adverse LV geometric remodeling and concentric hypertrophy in hypertensive patients.
- Lp(a) assessment may enhance cardiovascular risk stratification.
- Identifying high-risk hypertensive patients for target organ damage is crucial.
Background:
Lipoprotein(a) [Lp(a)] is an established cardiovascular risk factor associated with inflammation, endothelial dysfunction, oxidative stress, and arterial stiffness. Although elevated Lp(a) levels are linked to cardiovascular disease, their association with left ventricular (LV) geometric remodelling in hypertension remains incompletely understood. This study aimed to evaluate the relationship between serum Lp(a) levels and LV geometry in non-diabetic patients with essential hypertension.
Methods:
This cross-sectional observational study included 110 non-diabetic patients with essential hypertension. Patients were classified into low Lp(a) (<50 mg/dL, n=70) and elevated Lp(a) (≥50 mg/dL, n=40) groups. Comprehensive transthoracic echocardiography was performed to assess LV mass index (LVMI), relative wall thickness, and LV geometric patterns. Correlation and multivariate regression analyses were used to determine the independent association between Lp(a) levels and LV remodelling parameters.
Results:
Patients with elevated Lp(a) levels had significantly higher LVMI compared with those with lower levels (139.6±28.5 vs. 117.6±24.2 g/m², p<0.001). Concentric LV hypertrophy was more prevalent in the elevated Lp(a) group (55.0% vs. 20.0%, p=0.001). Serum Lp(a) levels were positively correlated with LVMI (r=0.357, p<0.001) and remained independently associated with LVMI after adjustment for clinical confounders (β=0.363, p<0.001). Elevated Lp(a) levels were also independently associated with increased odds of concentric LV hypertrophy.
Conclusions:
Elevated serum Lp(a) levels are independently associated with adverse LV geometric remodelling and concentric hypertrophy in non-diabetic patients with essential hypertension. Measurement of Lp(a) may provide additional information for cardiovascular risk stratification and early identification of hypertensive patients at risk for target organ damage.
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