ABSTRACT
BACKGROUND: Epidemiological studies suggest that apolipoprotein E (apoE) polymorphism influences plasma lipoprotein levels and the development of cardiovascular disease. OBJECTIVE: To clarify the role of apoE polymorphism as a risk factor for early atherosclerosis. DESIGN: Using a high-resolution ultrasound method, we investigated the association between apoE phenotypes, carotid intima-media thickness (CCA-IMT), and flow-mediated dilation in the brachial artery (brachial-FMD) in 96 healthy asymptomatic Japanese men (mean +/- SD age, 50 +/- 8 years). RESULTS: Serum cholesterol and LDL-cholesterol levels in subjects with E3E4 were highest and those with E2E3 were lowest (P < 0.05 and P < 0.05, respectively). The CCA-IMT in E3E4 subjects (0.76 +/- 0.17 mm) was greater than that in E2E3 and E3E3 (0.61 +/- 0.15 and 0.64 +/- 0.14 mm, respectively; P < 0.01). In contrast, there was no difference between brachial-FMD and apoE phenotypes (P=0.15). By univariate analysis, CCA-IMT was positively correlated with age (r=0.51, P < 0.01), LDL-chol/HDL-chol ratio (r=0.37, P < 0.01), triglycerides (r=0.23, P < 0.05), and negatively correlated with HDL-cholesterol (r=-0.31, P < 0.01). An association between CCA-IMT and the presence of E4 allele was also found (P < 0.05). Logistic regression analysis revealed that the presence of E4 allele was a higher risk for increased IMT (relative risk of 4.4, 95% CI 1.5-12.5), even after adjustment for age, LDL-cholesterol, blood pressure and other known risk factors. A negative correlation between brachial-FMD and CCA-IMT was also found in all subjects (r=-0.21, P < 0.05), being most apparent in the E3E4 subjects (r=-0.53, P < 0.02). CONCLUSION: ApoE4 phenotype was independently associated with an increased risk of carotid atherosclerosis and elevated LDL-cholesterol levels in asymptomatic middle-aged Japanese men.
Subject(s)
Apolipoproteins E/genetics , Asian People/genetics , Brachial Artery/physiopathology , Carotid Arteries/pathology , Carotid Stenosis/pathology , Carotid Stenosis/physiopathology , Tunica Intima/pathology , Tunica Media/pathology , Adult , Aged , Blood Flow Velocity , Brachial Artery/diagnostic imaging , Carotid Arteries/diagnostic imaging , Carotid Stenosis/diagnostic imaging , Carotid Stenosis/genetics , Endothelium, Vascular/diagnostic imaging , Endothelium, Vascular/physiopathology , Humans , Japan , Male , Middle Aged , Phenotype , Tunica Intima/diagnostic imaging , Tunica Media/diagnostic imaging , Ultrasonography , VasodilationABSTRACT
Heart uptake and clearance of 123I-15-(p-iodophenyl)-3(R,S)-methyl- pentadecanoic acid (BMIPP) by whole-body scintigraphy in relation to left ventricular ejection fraction (LVEF) was evaluated in 34 patients with ischaemic heart disease. At 45 and 210 min after injection, anterior whole-body images were obtained. In each patient, multigated blood pool scintigraphy was also performed, and LVEF was calculated. The percentage heart uptake of BMIPP did not have a significant correlation with LVEF (R = -0.299, NS). In contrast, there was a positive correlation between LVEF measured by multigated blood pool scintigraphy and BMIPP count density of the heart (R = 0.467, P = 0.005). Myocardial BMIPP washout rate also positively correlated with LVEF (R = 0.472, P = 0.005). In addition to these observations, there was a positive correlation between the BMIPP count density of the heart and myocardial BMIPP washout rate (R = 0.0543, P = 0.001). Thus, the BMIPP count density of the heart and myocardial BMIPP washout rate derived from BMIPP whole-body scintigraphy directly correlated with LVEF. However, the correlations between these parameters and LVEF were not strong enough to allow left ventricular dysfunction to be assessed precisely.
