Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure
Abstract Pulmonary hypertension secondary to heart failure (HF‐PH) combined with pulmonary vascular remodeling has a high mortality rate. Apolipoprotein A1 (ApoA1) has been shown to adversely affect outcomes in patients with HF. A prospective follow‐up study was performed on 239 consecutive patients...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-07-01
|
| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.12096 |
| _version_ | 1811178023752302592 |
|---|---|
| author | Wande Yu Xie Dujiang Wang Yi Ding Guanwen Zhang Mengyu Pan Chang Zhang Aikai Zhang Juan Zhu Linlin Zhang Hang |
| author_facet | Wande Yu Xie Dujiang Wang Yi Ding Guanwen Zhang Mengyu Pan Chang Zhang Aikai Zhang Juan Zhu Linlin Zhang Hang |
| author_sort | Wande Yu |
| collection | DOAJ |
| description | Abstract Pulmonary hypertension secondary to heart failure (HF‐PH) combined with pulmonary vascular remodeling has a high mortality rate. Apolipoprotein A1 (ApoA1) has been shown to adversely affect outcomes in patients with HF. A prospective follow‐up study was performed on 239 consecutive patients with HF‐PH who underwent right heart catheterization. Proteomics technology was used to analyze different proteins in plasma between post‐ and precapillary pulmonary hypertension (CpcPH) and isolated postcapillary pulmonary hypertension (IpcPH) filtered by propensity score matching. Ultimately, 175 patients were enrolled and followed for an average of 4.4 years. Lipoprotein components in plasma were measured, and the following clinical events were tracked. Proteomics data showed that lipid metabolism and inflammation were different between CpcPH and IpcPH. ApoA1 levels in HF‐PH patients with CpcPH were lower than those in HF‐PH patients with IpcPH. The patients with lower ApoA1 levels (≤1.025 g/L) were in a higher New York Heart Association class and had high levels of NT‐proBNP, mean pulmonary artery pressure, PVR, and diastolic pressure gradient. Besides, HF‐PH patients with lower ApoA1 levels had a 2.836‐fold higher relative risk of comorbid CpcPH compared with patients with higher ApoA1 levels. Moreover, patients with lower ApoA1 levels had a lower survival rate after adjusting for CpcPH. In conclusion, ApoA1 levels were negatively correlated with PVR levels. Lower ApoA1 levels were an independent risk factor for pulmonary vascular remodeling in HF‐PH patients. The survival of HF‐PH patients with lower ApoA1 levels was reduced. |
| first_indexed | 2024-04-11T06:11:16Z |
| format | Article |
| id | doaj.art-d12a2f7b4eaf47aab2c4f7f4b2756671 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-04-11T06:11:16Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-d12a2f7b4eaf47aab2c4f7f4b27566712022-12-22T04:41:16ZengWileyPulmonary Circulation2045-89402022-07-01123n/an/a10.1002/pul2.12096Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failureWande Yu0Xie Dujiang1Wang Yi2Ding Guanwen3Zhang Mengyu4Pan Chang5Zhang Aikai6Zhang Juan7Zhu Linlin8Zhang Hang9Division of Cardiology, Nanjing First Hospital Nanjing Medical University Nanjing ChinaDivision of Cardiology, Nanjing First Hospital Nanjing Medical University Nanjing ChinaDivision of Cardiology Nanjing Medical University Nanjing ChinaDepartment of Biology Nanjing Foreign Language School Nanjing ChinaDivision of Cardiology Nanjing Medical University Nanjing ChinaDivision of Cardiology, Nanjing First Hospital Nanjing Medical University Nanjing ChinaDivision of Cardiology Nanjing Medical University Nanjing ChinaDivision of Cardiology, Nanjing First Hospital Nanjing Medical University Nanjing ChinaDivision of Cardiology, Nanjing First Hospital Nanjing Medical University Nanjing ChinaDivision of Cardiology, Nanjing First Hospital Nanjing Medical University Nanjing ChinaAbstract Pulmonary hypertension secondary to heart failure (HF‐PH) combined with pulmonary vascular remodeling has a high mortality rate. Apolipoprotein A1 (ApoA1) has been shown to adversely affect outcomes in patients with HF. A prospective follow‐up study was performed on 239 consecutive patients with HF‐PH who underwent right heart catheterization. Proteomics technology was used to analyze different proteins in plasma between post‐ and precapillary pulmonary hypertension (CpcPH) and isolated postcapillary pulmonary hypertension (IpcPH) filtered by propensity score matching. Ultimately, 175 patients were enrolled and followed for an average of 4.4 years. Lipoprotein components in plasma were measured, and the following clinical events were tracked. Proteomics data showed that lipid metabolism and inflammation were different between CpcPH and IpcPH. ApoA1 levels in HF‐PH patients with CpcPH were lower than those in HF‐PH patients with IpcPH. The patients with lower ApoA1 levels (≤1.025 g/L) were in a higher New York Heart Association class and had high levels of NT‐proBNP, mean pulmonary artery pressure, PVR, and diastolic pressure gradient. Besides, HF‐PH patients with lower ApoA1 levels had a 2.836‐fold higher relative risk of comorbid CpcPH compared with patients with higher ApoA1 levels. Moreover, patients with lower ApoA1 levels had a lower survival rate after adjusting for CpcPH. In conclusion, ApoA1 levels were negatively correlated with PVR levels. Lower ApoA1 levels were an independent risk factor for pulmonary vascular remodeling in HF‐PH patients. The survival of HF‐PH patients with lower ApoA1 levels was reduced.https://doi.org/10.1002/pul2.12096ApoA1pulmonary hypertensionpulmonary hypertension secondary to heart failurepulmonary vascular remodeling |
| spellingShingle | Wande Yu Xie Dujiang Wang Yi Ding Guanwen Zhang Mengyu Pan Chang Zhang Aikai Zhang Juan Zhu Linlin Zhang Hang Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure Pulmonary Circulation ApoA1 pulmonary hypertension pulmonary hypertension secondary to heart failure pulmonary vascular remodeling |
| title | Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure |
| title_full | Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure |
| title_fullStr | Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure |
| title_full_unstemmed | Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure |
| title_short | Apolipoprotein A1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure |
| title_sort | apolipoprotein a1 is associated with pulmonary vascular resistance and adverse clinical outcomes in patients with pulmonary hypertension secondary to heart failure |
| topic | ApoA1 pulmonary hypertension pulmonary hypertension secondary to heart failure pulmonary vascular remodeling |
| url | https://doi.org/10.1002/pul2.12096 |
| work_keys_str_mv | AT wandeyu apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT xiedujiang apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT wangyi apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT dingguanwen apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT zhangmengyu apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT panchang apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT zhangaikai apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT zhangjuan apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT zhulinlin apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure AT zhanghang apolipoproteina1isassociatedwithpulmonaryvascularresistanceandadverseclinicaloutcomesinpatientswithpulmonaryhypertensionsecondarytoheartfailure |