ABSTRACT
BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol(TCL), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), and triglycerides(TG)]and right ventricle end diastolic diameter (RVEDD), left ventricle end diastolic diameter (LVEDD), right atrium diameter (RA), left atrium diameter (LA), or left ventricle ejection fraction (LVEF) were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD (r=-0.34,P<0.001) and RA (r=-0.36,P<0.001). Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.
ABSTRACT
Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid (UA) metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical characteristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure (n = 553). By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid (SUA) formed part of a principal cluster of renal functional variables which included serum creatinine (SCr) and blood urea nitrogen (BUN). Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN (r = 0.48, P < 0.001) and SCr (r = 0.47, P < 0.001). Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.
ABSTRACT
Objective To determine efficacy and safety of intensive lipid lowering with atorvastatin made in China in coronary artery disease(CAD)patients with high risk factors.Methods We enrolled 104 CAD patients admitted to our hospital with high risk Factors.All patients were randomized to either low dose of atorvastatin group(n=50,10 mg/daily)or large dose of atorvastatin group(n=54,40 mg/daily)for 6 months.Total cholesterol(TC),low den- sity lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),triglycerides(TG),serum glucose,hepatic function,renal function,ereatine kinase(CK)of the patients were measured before treatment and at 1 month,3 months,6 months,respectively.Results After six-month treatment,LDL-C,TC,TG levels were reduced by 38.04%,29.37%,20.74%,respectively in the low dose atorvastatin group compared with baseline; whereas reduced by 49.14%,37.69%,26.98%,respectively in the high dose atorvastatin group as compared with baseline level.As for HDL-C,it was increase of 5.98% in low dose atorvastatin group and 3.48% in high dose atorv- astatin group.Responder rates were 54.00% in low dose of atorvastatin group and 79.24% in large dose of atorvastatin group.Much more patients in the high dose atorvastatin group achieved LDL cholesterol goal compare with low dose ator- vastatin group(P