关键词: 血脂, 总胆固醇, 低密度脂蛋白胆固醇, 心功能, 冠心病

Abstract:

Objective To investigate the correlation between blood lipid levels and cardiac function indexes in patients with coronary heart disease（CHD）. Methods A total of 200 CHD patients（CHD group） and 200 healthy subjects（control group） in Jiangsu Shuyang Zhongxing Hospital from January 2021 to January 2022 were enrolled. Serum total cholesterol（TC），triglyceride（TG），low-density lipoprotein cholesterol（LDL-C），high-density lipoprotein cholesterol（HDL-C），small and dense low-density lipoprotein cholesterol（sd-LDL-C），apolipoprotein（apo）A and apo B，apo E，lipoprotein（a） [Lp（a）] and lipoprotein-associated phospholipase A2（Lp-PLA2） levels were determined. Cardiac function indexes [end-diastolic volume（EDV），end-systolic volume（ESV），left ventricular ejection fraction（LVEF）] were determined. Pearson correlation analysis，multiple linear correlation analysis and Logistic regression analysis were used to evaluate the relationship between blood lipid levels and cardiac function indexes. Results The levels of apo B，apo E，Lp（a），Lp-PLA2，LDL-C，TG and TC levels and EDV and ESV in CHD group were higher than those in control group（P<0.001），and serum HDL-C and apo A levels and LVEF were lower than those in control group（P<0.001）. There was no statistical significance in serum sd-LDL-C levels between the 2 groups（P>0.05）. Pearson correlation analysis showed that apo B，apo E，Lp（a），Lp-PLA2，LDL-C，TG and TC were positively correlated with EDV and ESV（P<0.001），and they were negatively correlated with LVEF（P<0.001）. HDL-C and apo A were negatively correlated with EDV and ESV（P<0.001），and they were positively correlated with LVEF（P<0.05）. EDV and ESV increased by 0.130 and 0.110 mm for each 1 mmol/L increase of LDL-C（β=0.130 and 0.110）. EDV and ESV increased by 0.220 and 0.189 mm for each 1 mmol/L increase of TC（β= 0.220 and 0.189）. For each 1 mmol/L increase of TC，LVEF decreased by 0.310%（β=-0.310）. EDV and ESV of LDL-C>3.40 mmol/L group and TC>5.17 mmol/L group were higher than those of LDL-C≤3.40 mmol/L group and TC≤5.17 mmol/L group，respectively（P<0.001），and LVEF was lower than LDL-C≤3.40 mmol/L group and TC≤5.17 mmol/L group，respectively（P<0.001）. Logistic regression analysis showed that after adjusting for age，sex，body mass index and diabetes mellitus history，LDL-C>3.40 mmol/L and TC>5.17 mmol/L were risk factors for increasing EDV and ESV and decreasing LVEF（P<0.001）. Conclusions TC and LDL-C are correlated with cardiac function in patients with CHD. Abnormal lipid metabolism may be involved in the pathological process of heart failure in patients with CHD.

Key words: Blood lipid, Total cholesterol, Low-density lipoprotein cholesterol, Cardiac function, Coronary heart disease