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Serum High-Density Lipoprotein Cholesterol is Significantly Associated with the Presence and Severity of Pulmonary Arterial Hypertension: A Retrospective Cross-Sectional Study

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Abstract

Introduction

To explore the relationship between serum high-density lipoprotein cholesterol (HDL-C) levels and the presence and severity of pulmonary arterial hypertension (PAH).

Methods

A total of 177 patients with PAH and 103 patients without pulmonary hypertension (PH) were enrolled in this study. All patients underwent right heart catheterization (RHC) for diagnosing and assessing the severity of PAH. Demographics, comorbidities, and laboratory data including serum HDL-C levels were collected.

Results

Plasma HDL-C levels in patients with PAH were significantly lower compared with patients without PH (1.08 ± 0.36 vs 1.49 ± 0.36, p < 0.001). HDL-C levels positively correlated with cardiac output (r = 0.360, p < 0.001), cardiac index (r = 0.337, p < 0.001), and mixed venous oxygen saturation (r = 0.426, p < 0.001), and negatively with mean pulmonary arterial pressure (r = − 0.529, p < 0.001), right atrial pressure (r = − 0.421, p < 0.001), and pulmonary vascular resistance (r = − 0.583, p < 0.001). Multivariate logistic regression analysis indicated that HDL-C was a significant independent predictor of PAH (OR 0.042, 95% CI 0.006–0.304, p = 0.002). The receiver operating characteristic curve analysis showed that the optimal cutoff value of the serum HDL-C concentration for predicting PAH was 1.32 mmol/L, with a sensitivity of 83.6% and a specificity of 72.8% (area under the curve 0.803, 95% confidence interval 0.750–0.856, p < 0.001).

Conclusions

Serum HDL-C is a simple biomarker that might be used for prediction and assessment of PAH in Chinese Han ethnicity, and the mechanism underlying the association needs further study.

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Acknowledgements

We would like to acknowledge the contribution of the staff at the Cardiac Catheter Laboratories units at Zhongshan Hospital.

Funding

The study was supported by the Shanghai Science and Technology Development Founding, China No. 14ZR1406700. The journal’s Rapid Service Fee was funded by the authors.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Authorship Contributions

Gao-Feng Wang and Li-Hua Guan contributed equally to this article.

Disclosures

Gao-Feng Wang, Li-Hua Guan, Da-Xin Zhou, Dan-Dan Chen, Xiao-Chun Zhang, and Jun-Bo Ge have nothing to disclose.

Compliance with Ethics Guidelines

This study was approved by the Ethics Committee of the Zhongshan Hospital, Fudan University. Because this retrospective study was based on data from patient medical records, written informed consent was not obtained from the participants.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Cardiology, Shanghai Institute of Cardiovascular Disease, Zhongshan Hospital, Fudan University, Shanghai, China

    Gao-Feng Wang, Li-Hua Guan, Da-Xin Zhou, Dan-Dan Chen, Xiao-Chun Zhang & Jun-BO Ge

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  1. Gao-Feng Wang
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  2. Li-Hua Guan
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Corresponding author

Correspondence to Da-Xin Zhou.

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Wang, GF., Guan, LH., Zhou, DX. et al. Serum High-Density Lipoprotein Cholesterol is Significantly Associated with the Presence and Severity of Pulmonary Arterial Hypertension: A Retrospective Cross-Sectional Study. Adv Ther 37, 2199–2209 (2020). https://doi.org/10.1007/s12325-020-01304-2

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