title: Impaired cholesterol efflux capacity and vasculoprotective function of high-density lipoprotein in heart transplant recipients.
abstract: BACKGROUND
  High-density lipoprotein (HDL) metabolism is significantly altered in heart transplant recipients. We hypothesized that HDL function may be impaired in these patients.
  
  
  METHODS
  Fifty-two patients undergoing coronary angiography between 5 and 15 years after heart transplantation were recruited in this cross-sectional study. Cholesterol efflux capacity of apolipoprotein B-depleted plasma was analyzed using a validated assay. The vasculoprotective function of HDL was studied by means of an endothelial progenitor cell migration assay.
  
  
  RESULTS
  HDL cholesterol levels were similar in heart transplant patients compared with healthy controls. However, normalized cholesterol efflux and vasculoprotective function were reduced by 24.1% (p < 0.001) and 27.0% (p < 0.01), respectively, in heart transplant recipients compared with healthy controls. HDL function was similar in patients with and without cardiac allograft vasculopathy (CAV) and was not related to C-reactive protein (CRP) levels. An interaction effect (p = 0.0584) was observed between etiology of heart failure before transplantation and steroid use as factors of HDL cholesterol levels. Lower HDL cholesterol levels occurred in patients with prior ischemic cardiomyopathy who were not taking steroids. However, HDL function was independent of the etiology of heart failure before transplantation and steroid use. The percentage of patients with a CRP level ≥6 mg/liter was 3.92-fold (p < 0.01) higher in patients with CAV than in patients without CAV.
  
  
  CONCLUSIONS
  HDL function is impaired in heart transplant recipients, but it is unrelated to CAV status. The proportion of patients with a CRP level ≥6 mg/liter is prominently higher in CAV-positive patients.
authors.affiliation: Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Neha
authors.initials: N
authors.lastname: Singh
authors.affiliation: Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Jacobs
authors.affiliation: Institute for Translational Medicine and Therapeutics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rader
authors.affiliation: Division of Cardiology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Vanhaecke
authors.affiliation: Division of Cardiology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Van Cleemput
authors.affiliation: Centre for Molecular and Vascular Biology, Department of Cardiovascular Sciences, Catholic University of Leuven, Leuven, Belgium. Electronic address: bart.degeest@med.kuleuven.be.
authors.forename: Bart
authors.initials: B
authors.lastname: De Geest
mesh_terms: D064591:Allografts; D000818:Animals; D002097:C-Reactive Protein / Q000378:metabolism; D002784:Cholesterol / Q000097:blood*; D017023:Coronary Angiography; D003430:Cross-Sectional Studies; D004195:Disease Models, Animal; D066026:Endothelial Progenitor Cells / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood* / Q000473:pathology; D016027:Heart Transplantation; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008875:Middle Aged; D011379:Prognosis; D013997:Time Factors
chemical_list: D008075:Lipoproteins, HDL; D002097:C-Reactive Protein; D002784:Cholesterol
keywords: HDL function; cardiac allograft vasculopathy; cholesterol efflux; endothelial progenitor cell; heart transplantation