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[Hyperlipoproteinemia in patients after heart transplantation]
E Goncalvesová1, J Fabián, Z Schreinerová
1Transplantacné oddelenie Slovenskéko ústavu srdcových a cievnych chorôb v Bratislave, Slovakia.
Insights
Hyperlipidaemia is common after heart transplantation and linked to graft vascular disease. Obesity showed a correlation with lipid levels, but glucose tolerance and prednisone dose did not significantly impact lipid profiles post-transplant.
Area of Science:
- Cardiology
- Transplantation Medicine
- Metabolic Disorders
Context:
- Hyperlipidaemia (HLP) is a prevalent metabolic disorder following heart transplantation (HTx).
- Graft vascular disease (GVD) is a primary cause of mortality post-HTx, with HLP implicated in its pathogenesis.
- Understanding HLP's role is crucial for improving long-term outcomes in heart transplant recipients.
Purpose:
- To analyze lipid profiles (Total Cholesterol, Triglycerides, HDL-C, LDL-C) in patients over one year post-HTx.
- To investigate the association of HLP with underlying conditions (dilated cardiomyopathy, coronary artery disease) and treatments (prednisone dose, glucose tolerance).
- To identify factors contributing to the pathogenesis of HLP after heart transplantation.
Summary:
- Lipid levels were assessed in 35 heart transplant patients. High levels of TC (83%), TAG (43%), LDL-C (80%), and low HDL-C (75%) were frequently observed.
- No significant differences in lipid parameters were found based on the cause of HTx (D-KMP vs. CAD), glucose tolerance, or prednisone dosage.
- A significant linear correlation was confirmed between Body Mass Index (BMI) and both triglycerides (TAG) and HDL-cholesterol (HDL-C).
Impact:
- This study highlights the high prevalence of dyslipidemia post-heart transplantation, underscoring the need for vigilant lipid management.
- While obesity is a contributing factor, other common post-transplant factors like glucose intolerance and prednisone dose appear less directly influential on lipid profiles.
- Findings suggest a complex pathogenesis of HLP after HTx, necessitating further research into multifactorial causes and targeted interventions to mitigate GVD risk.
Abstract:
Hyperlipidaemia is one of the most frequent metabolic disorders after heart transplantation (HTx). The significance of hyperlipidaemia is stressed mainly in relation to graft vascular disease (GVD) which is the leading cause of death more than one year after transplantation. Recently the evidence on the role of hyperlipidaemia (HLP) in the pathogenesis of GVD is growing. Total cholesterol (TC), triglycerides (TAG) HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) were analysed cross-sectionally in 35 patients (30 males), aged 20-64 (median 40) years, more than one year after HTx. In 25 patients HTx was performed because of dilated cardiomyopathy (D-KMP), in 10 because of coronary artery disease (CAD). TC more than 5.6 mmol/l was detected in 29 (83%), TAG > 2.3 mmol/l in 15 (43%), LDL-C >3.6 mmol/l in 28 (80%) and HDL-C < 1.4 mmol/l in 25 (75%) of patients. There were no statistically significant differences in evaluated parameters found between the groups of patients operated on because of CAD and D-CMP, with and without glucose tolerance disorder and groups treated with higher (> 5 mg/D) and lower (.5 mg/D) dose of prednisone. Significant linear correlation of body mass index (BMI) and TAG or BMI and HDL/C resp. was confirmed. Pathogenesis of HLP after HTx is complex. Except of obesity, no unambiguous evidence of the role of glucose tolerance disorder or prednisone dose in immunosuppressive treatment were found. (Tab. 2, Fig. 3, Ref. 21.)