HDL-particle subfractions in heart failure

Authors: Murín J. 1;  Bulas J. 1;  Gašpar Ľ. 1;  Klabník A. 2;  Wawruch M. 3
Authors‘ workplace: I. interná klinika LF UK a UN Bratislava 1;  Kardiologická ambulancia, Oravská poliklinika, Námestovo 2;  Ústav farmakológie a klinickej farmakológie LF UK, Bratislava 3
Published in: Kardiol Rev Int Med 2019, 21(3): 168-170


For some decades there has been an interest in investigat­ing the role of HDL particles in cardiovascular dis­eases. The Framingham Heart Study discovered that people with high serum HDL-C levels usually have low cardiovascular risk. This was the background of ‘HDL –  hypothesis’: that with an increase of serum HDL-C levels, we can reduce cardiovascular morbidity and mortality. The hypothesis was not confirmed by large clinical trials (with niacin, with CETP inhibitors), even though there was an increase of serum HDL-C level detected. These results stimulated analysis of HDL particles and their pleiotropic actions were discovered: small and more dense HDL particles had greater cholesterol efflux, together with anti-inflammatory and anti-oxidative activities, than the larger and less dense HDL particles. In patients with an increase of small and dense HDL particles in serum, there was lower risk of ischaemic heart dis­ease, carotid atherosclerosis and of cardiovascular events and death. In this paper, we present data about subfractions of HDL particles in heart failure (782 patient with systolic heart failure and 1,004 patients with diastolic heart failure): 1. larger HDL particles were observed in patients with systolic heart failure and smaller HDL particles were observed in patients with diastolic heart failure; 2. The presence of small HDL particles in serum of patients with heart failure improved the patients’ prognosis, as these patients suffered from less cardivascular events dur­ing the follow-up. Therefore, the presence of HDL subfractions is a marker of residual cardiovascular risk in heart failure patients.


HDL particle – HDL subfractions – treatment – cardiovascular events


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Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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