title: Association of serum total bilirubin levels with diastolic dysfunction in heart failure with preserved ejection fraction.
abstract: BACKGROUND
  Left ventricular diastolic dysfunction is one of the main characteristics of heart failure patients with a preserved left ventricular ejection fraction. As bilirubin is regarded as an important endogenous antioxidant molecule, serum total bilirubin levels were compared between heart failure patients with a preserved left ventricular ejection fraction and normal controls in this study. We recruited 327 heart failure patients with a preserved left ventricular ejection fraction and 200 healthy controls. Patients were divided into 4 subgroups by their comprehensive echocardiographic manifestations, 1-mild, 2-moderate, 3-severe (reversible restrictive), 4-severe (fixed restrictive). Total bilirubin levels were compared using stepwise multiple regressions adjusted for selected factors.
  
  
  RESULTS
  After adjusting for gender, age, smoking, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride, serum total bilirubin levels were significantly lower in the heart failure group compared with the control group (P < 0.01). Patients in the subgroup (4-severe) showed significantly (P < 0.05) lower levels of total bilirubin when compared with the subgroup (1-mild).
  
  
  CONCLUSIONS
  TB level was negatively correlated with left ventricular diastolic dysfunction in heart failure patients with a preserved left ventricular ejection fraction, which might provide a new insight into the complicated mechanisms of heart failure with a preserved left ventricular ejection fraction.
authors.forename: Huan
authors.initials: H
authors.lastname: Zheng
authors.forename: Ye
authors.initials: Y
authors.lastname: Li
authors.forename: Nanzi
authors.initials: N
authors.lastname: Xie
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000975:Antioxidants / Q000378:metabolism; D001663:Bilirubin / Q000097:blood*; D001794:Blood Pressure; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D004452:Echocardiography; D005260:Female; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000145:classification / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012907:Smoking; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology*; D014280:Triglycerides / Q000032:analysis; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D000975:Antioxidants; D014280:Triglycerides; D002784:Cholesterol; D000410:Alanine Transaminase; D001663:Bilirubin