Key result
Individuals with pulmonary hypertension had significantly lower HDL-C (41 vs 56 mg/dL) compared to healthy controls, and lower total cholesterol correlated with worse right ventricular function.
Why the study?
Blood lipids are dysregulated in PH, but whether dyslipidemia is associated with RV dysfunction—the major determinant of morbidity and mortality in PH—remains to be tested.
Cross-Sectional (n=42)
No
Absolute Event Rate: 41% vs 56%
p-value: p=<0.01
In patients with pulmonary hypertension, lower levels of total cholesterol and triglycerides paradoxically correlate with worse right ventricular function and higher NT-proBNP levels, suggesting a link between lipid metabolism and RV failure.
Dyslipidemia may signal worse RV function in PH; leaves open causal links and therapeutic implications pending larger studies.
Background Blood lipids are dysregulated in pulmonary hypertension (PH). Lower high-density lipoproteins cholesterol (HDL-C) and low-density lipoproteins cholesterol (LDL-C) are associated with disease severity and death in PH. Right ventricle (RV) dysfunction and failure are the major determinants of morbidity and mortality in PH. This study aims to test the hypothesis that dyslipidemia is associated with RV dysfunction in PH. Methods We enrolled healthy control subjects (n=12) and individuals with PH (n=30) (age: 18-65 years old). Clinical characteristics, echocardiogram, 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography (PET) scan, blood lipids, including total cholesterol (TC), triglycerides (TG), lipoproteins (LDL-C and HDL-C), and N-terminal pro-B type Natriuretic Peptide (NT-proBNP) were determined. Results Individuals with PH had lower HDL-C [PH, 41±12; control, 56±16 mg/dL, p <0.01] and higher TG to HDL-C ratio [PH, 3.6±3.1; control, 2.2±2.2, p<0.01] as compared to controls. TC, TG, and LDL-C were similar between PH and controls. Lower TC and TG were associated with worse RV function measured by RV strain ( R =–0.43, p =0.02 and R= –0.37, p =0.05 respectively), RV fractional area change ( R =0.51, p <0.01 and R =0.48, p <0.01 respectively), RV end-systolic area ( R =–0.63, p <0.001 and R =–0.48, p <0.01 respectively), RV end-diastolic area: R =–0.58, p <0.001 and R =–0.41, p =0.03 respectively), and RV glucose uptake by PET ( R =–0.46, p =0.01 and R =–0.30, p =0.10 respectively). NT-proBNP was negatively correlated with TC ( R = – 0.61, p =0.01) and TG ( R =–0.62, p <0.02) in PH. Conclusion These findings confirm dyslipidemia is associated with worse right ventricular function in PH.
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Fakhry et al. (2024) conducted a cross-sectional in Pulmonary Hypertension (n=42). Pulmonary hypertension vs. Healthy controls was evaluated on HDL-C levels (mg/dL) (p=<0.01). Individuals with pulmonary hypertension had significantly lower HDL-C (41 vs 56 mg/dL) compared to healthy controls, and lower total cholesterol correlated with worse right ventricular function.
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