Reduced antioxidant high-density lipoprotein function in heart failure with preserved ejection fraction
B Sasko, T Kelesidis, S Kostin, L Scharow… - Clinical Research in …, 2025 - Springer
B Sasko, T Kelesidis, S Kostin, L Scharow, R Mueller, M Jaensch, J Wintrich, M Christ…
Clinical Research in Cardiology, 2025•SpringerBackground Heart failure (HF) is a heterogeneous clinical syndrome affecting a growing
global population. Due to the high incidence of cardiovascular risk factors, a large proportion
of the Western population is at risk for heart failure. Oxidative stress and inflammation play a
crucial role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF).
While previous studies have demonstrated an association between dysfunctional HDL and
heart failure, the specific link between oxidized HDL and HF remains unexplored. Methods …
global population. Due to the high incidence of cardiovascular risk factors, a large proportion
of the Western population is at risk for heart failure. Oxidative stress and inflammation play a
crucial role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF).
While previous studies have demonstrated an association between dysfunctional HDL and
heart failure, the specific link between oxidized HDL and HF remains unexplored. Methods …
Abstract
Background
Heart failure (HF) is a heterogeneous clinical syndrome affecting a growing global population. Due to the high incidence of cardiovascular risk factors, a large proportion of the Western population is at risk for heart failure. Oxidative stress and inflammation play a crucial role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF). While previous studies have demonstrated an association between dysfunctional HDL and heart failure, the specific link between oxidized HDL and HF remains unexplored.
Methods
In this cross-sectional observational study, the antioxidant function of HDL was assessed in 366 patients with suspected heart failure. HFpEF assessment was conducted according to current guidelines. A validated cell-free biochemical assay was used to determine reduced HDL antioxidant function as assessed by increased HDL-lipid peroxide content (HDL ox), normalized by HDL-C levels and the mean value of a pooled serum control from healthy participants (nHDL ox; no units). Results were expressed as median with interquartile range (IQR).
Results
Participants with HFpEF (n= 88) had 15% higher mean relative levels of nHDL ox than those without heart failure (n= 180). Using a basic multivariate model adjusted for age, sex, eGFR and a full multivariate model (adjusted for diabetes, hypertension, atrial fibrillation, LDL cholesterol, hsCRP, and coronary artery disease), nHDL ox was an independent predictor for HFpEF (p< 0.05). An increase in 1-SD in nHDL ox was associated with a 67% increased risk for HFpEF if compared with participants without heart failure (p= 0.02).
Conclusion
HDL antioxidant function is reduced in patients with HFpEF. Improving HDL function is a promising target for early heart failure treatment.
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