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Changes in Plasma LDL and HDL Composition in Patients Undergoing Cardiac Surgery

  • Original Article
  • Published:
Lipids

Abstract

Changes of lipoprotein composition have been mainly reported in conditions of sepsis. This study characterized compositional changes in LDL and HDL during the acute phase response following cardiac surgery with cardiopulmonary bypass. Twenty-one patients undergoing cardiac surgery were included in this study. Blood samples were drawn before operation and on day 2 post-surgery. In parallel to plasma lipids and antioxidant status, lipoproteins were analyzed for lipid, apolipoprotein (apo), hydroperoxide and alpha-tocopherol content. Beyond decreases in lipid concentrations and antioxidant defenses, cardiac surgery induced substantial modifications in plasma lipoproteins. ApoB decrease in LDL fraction (−46%; P < 0.0001) reflected a marked reduction in the circulating particle number. LDL cholesteryl ester content relative to apoB concentration remained unchanged post-surgery while triglyceride (+113%; P < 0.001), free cholesterol (+22%; P < 0.05) and phospholipid (+23%; P < 0.025) were raised relative to apoB indicating increased particle size. In HDL, an abrupt rise of apoSAA (P < 0.05) was observed together with a decrease of apoA1 (−22%; P < 0.005). Cholesteryl ester content in HDL fraction decreased in parallel to apoA1 concentration while triglycerides, free cholesterol and phospholipids increased relative to apoA1. In contrast to unchanged alpha-tocopherol content, hydroperoxide content was increased in LDL and HDL. By comparison to sepsis, cardiac surgery induces a comparable reduction in circulating LDL but a more limited decrease in HDL particles. Furthermore, in contrast, cardiac surgery induces an increase in polar and non-polar lipids, as well as of particle size in both LDL and HDL.

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Abbreviations

Apo:

Apolipoproteins

CE:

Cholesteryl ester

FC:

Free cholesterol

HDL:

High density lipoproteins

LDL:

Low density lipoproteins

PON:

Paraoxonase

SAA:

Serum amyloid A

TC:

Total cholesterol

TG:

Triglycerides

TAOS:

Total antioxidant status

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Acknowledgments

Part of this study was presented in abstract form at the conference of the New York Academy of Science “vitamin E and Health”, Boston (2004) [57]. The authors gratefully thank Dr. R.J. Deckelbaum (Institute of Human Nutrition, Columbia University, New York, USA) for helpful discussions and advice.

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Authors and Affiliations

  1. L. Deloyers Laboratory for Experimental Surgery, Erasme Hospital, Université Libre de Bruxelles, Avenue J. Wybran 40, 1070, Brussels, Belgium

    M. Hacquebard, W. J. Malaisse & Y. A. Carpentier

  2. Department of Anesthesia, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium

    A. Ducart & D. Schmartz

Authors
  1. M. Hacquebard
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  2. A. Ducart
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  3. D. Schmartz
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  4. W. J. Malaisse
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  5. Y. A. Carpentier
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Corresponding author

Correspondence to Y. A. Carpentier.

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M. Hacquebard is recipient of a fellowship from the Danone Institute, Belgium.

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Hacquebard, M., Ducart, A., Schmartz, D. et al. Changes in Plasma LDL and HDL Composition in Patients Undergoing Cardiac Surgery. Lipids 42, 1143–1153 (2007). https://doi.org/10.1007/s11745-007-3114-9

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  • DOI: https://doi.org/10.1007/s11745-007-3114-9

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