Atrial fibrillation is associated with alterations in HDL function, metabolism, and particle number

  • Markus Trieb
  • Jelena Kornej
  • Eva Knuplez
  • Gerhard Hindricks
  • Holger Thiele
  • Philipp Sommer
  • Hubert Scharnagl
  • Nikolaos Dagres
  • Borislav Dinov
  • Andreas Bollmann
  • Daniela Husser
  • Gunther MarscheEmail author
  • Petra BuettnerEmail author
Original Contribution


Increased morbidity and mortality in atrial fibrillation (AF) are related to the pro-fibrotic, pro-thrombotic, and pro-inflammatory processes that underpin the disease. High-density lipoproteins (HDL) have anti-inflammatory, anti-oxidative, and anti-thrombotic properties. Functional impairment of HDL may, therefore, associate with AF initiation or progression. We studied indices of HDL quality and quantity of AF patients and healthy controls, including HDL-particle number, HDL cholesterol, apolipoprotein (apo) A–I levels, serum amyloid A (SAA) content and HDL-cholesterol efflux capacity, and paraoxonase activity of apoB-depleted serum. Serum samples were collected from AF patients (n = 91) before catheter ablation and from age- and sex-matched control subjects (n = 54). HDL-cholesterol efflux capacity was assessed in a validated assay using [3H]-cholesterol-labeled J774 macrophages. Lecithin–cholesterol acyltransferase (LCAT) and paraoxonase activities were assessed using fluorometric assays, SAA levels were determined by ELISA, and total and subclass HDL-particle number was assessed by nuclear magnetic resonance spectroscopy. ApoA-I levels were determined by immunoturbidimetry. HDL-cholesterol efflux capacity, HDL-particle number, apoA-I levels, and LCAT activity were markedly reduced in AF patients when compared to healthy individuals (all p < 0.001), whereas HDL-associated paraoxonase activity and SAA content were not altered (p = 0.578, p = 0.681). Notably, cholesterol efflux capacity, HDL-particle number, apoA-I levels as well as LCAT activity recovered following restoration of sinus rhythm (all p < 0.001). We identified marked alterations in HDL function, HDL maturation, and HDL-particle number in AF patients. Assessing HDL-particle number and function in AF may be used as a surrogate marker of AF onset and progression and may help identifying patients at high risk.


Atrial fibrillation HDL function Cholesterol efflux capacity HDL-particle number PON 



This work was supported by the Austrian Science Fund FWF (FWF W1241, DK-MOLIN, and P22976-B18 to GM). PB and DH were supported by the Volkswagen Foundation Germany through the Lichtenberg professorship program to DH (#84901)

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

395_2019_735_MOESM1_ESM.docx (7.3 mb)
Supplementary material 1 (DOCX 7429 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Markus Trieb
    • 2
    • 4
  • Jelena Kornej
    • 1
  • Eva Knuplez
    • 2
  • Gerhard Hindricks
    • 1
  • Holger Thiele
    • 3
  • Philipp Sommer
    • 1
  • Hubert Scharnagl
    • 5
  • Nikolaos Dagres
    • 1
  • Borislav Dinov
    • 1
  • Andreas Bollmann
    • 1
  • Daniela Husser
    • 1
  • Gunther Marsche
    • 2
    • 4
    Email author
  • Petra Buettner
    • 1
    • 3
    Email author
  1. 1.Department of ElectrophysiologyHeart Center Leipzig-University Hospital of CardiologyLeipzigGermany
  2. 2.Division of Pharmacology, Otto Loewi Research CenterMedical University of GrazGrazAustria
  3. 3.Department of Internal Medicine/CardiologyHeart Center Leipzig-University Hospital of CardiologyLeipzigGermany
  4. 4.BioTechMed-GrazGrazAustria
  5. 5.Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University of GrazGrazAustria

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