Predictive value of remnant cholesterol for left ventricular hypertrophy and prognosis in hypertensive patients with heart failure: a prospective study

• Published in: Lipids in health and disease Vol. 23; no. 1; pp. 294 - 9
• Main Authors: Wang, Zeyu, Zhu, Zhaoxin, Shen, Jianying, Zhang, Yan, Wang, Ting, Xu, Yawei, Jiang, Dongyang, Liu, Weijing
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 12.09.2024; BioMed Central; BMC
• Subjects: Aged; Analysis; Antihypertensive drugs; Antilipemic agents; Canada; Cholesterol; Cholesterol - blood; Cholesterol, HDL - blood; Complications and side effects; Female; Health aspects; Heart; Heart enlargement; Heart failure; Heart failure (HF); Heart Failure - blood; Heart Failure - complications; Heart Failure - mortality; Humans; Hypertension; Hypertension - blood; Hypertension - complications; Hypertrophy, Left Ventricular - blood; Left ventricular hypertrophy (LVH); Male; Medical research; Medicine, Experimental; Middle Aged; Mortality; Physiological aspects; Prognosis; Proportional Hazards Models; Prospective Studies; Remnant cholesterol (RC); Risk Factors; ROC Curve; Taiwan; Triglycerides; Triglycerides - blood; Ventricular Remodeling; China; Canada; Taiwan; Hypertension; Prognosis; Left ventricular hypertrophy (LVH); Remnant cholesterol (RC); Heart failure (HF)
• ISSN: 1476-511X; 1476-511X
• DOI: 10.1186/s12944-024-02282-y

Remnant cholesterol (RC) is substantially related to negative outcomes in cardiac patients. Patients with coexisting hypertension and heart failure (HF) often develop left ventricular hypertrophy (LVH) and have poor prognoses. This study investigated baseline RC levels and LV remodelling and patients' prognoses. Six hundred thirty consecutive individuals with hypertension and HF participated in this prospective trial from October 2018 to August 2020. Based on left ventricular mass index (LVMI), 560 those eligible were separated into LVH and non-LVH groups. Multiple linear regression and receiver operating characteristic (ROC) curves examined the RC and LV relationship. A Cox regression analysis was conducted to examine the predictive value of RC for clinical outcomes. The LVH group presented significantly elevated values of RC, triglyceride, and cholesterol and decreased high-density lipoprotein cholesterol (HDLC). The optimal cutoff value for RC to predict LV remodelling was 0.49. The subjects were observed for a median of 58 months, and 104 participants met the primary endpoint. The risk models involving the two Cox models were adjusted to incorporate confounding factors, which revealed that those with elevated baseline levels of RC were more susceptible to cardiovascular mortality, as shown by an increased hazard ratio. (HR: 1.91, 95% CI: 1.62-2.26 vs. HR: 1.75, 95% CI: 1.43-2.16, P < 0.001). RC is linked to LV remodelling in patients with hypertensive HF, with LVH having greater RC values. Moreover, patients with hypertensive HF who had a higher RC suffered from an increased risk of cardiovascular mortality. NCT03727828, 21 Oct 2018.