Aortic valve involvement in familial heterozygous hypercholesterolaemia: An echocardiographic study

Friday, 28 May ] 999 Poster presentation: Epidemiology of atherosclerosis: ethnic, nutritional, psychosocial and genetic factors nethod 284 control individuals (147 women and 137 men) from the general celandic population were genotyped for this polymorphism. For comparison ,enotyping was carried out on 360 individuals (77 women and 283 men) vho had survived a definite myocardial infarction (MI), participants in the ~,eykjavik Study, a 30 year long prospective study of cardiovascular risk actors. The frequency of the Asn9 was 2% in both controls and cases and he polymorphism was in Hardy-Weinberg equilibrium. When the effect of his polymorphism was examined, there was a statistically significant effect )f the Asn9 allele on plasma triglyceride levels in women only. This was ;een both in the cases and the controls (p < 0.05 for both). In men the same rend was seen, but it did not reach statistical significance. There was no ;tatistically significant effect on plasma levels of HDL, although the Ash9 :arriers always had lower levels. These results indicate that although there is i significant effect of the Asn9 allele in the LPL, there is no evident effect ~f the polymorphism on the risk o f MI in the sample of this size from the ~omogeneous Icelandic population. ~,ORTIC VALVE INVOLVEMENT IN FAMILIAL H E T E R O Z Y G O U S ~IYPERCHOLESTEROLAEMIA: AN E C H O C A R D I O G R A P H I C ~TUDY

• Rallidis, E Nihoyannopoulos 1, G. Tsitouris, G.R. Thompson 2. 2nd 9epartment of Cardiology. Euangelismos Hospital, Athens, Greece; IDepartment off Medicine, Clinical Cardiology; 2MRC Lipoprotein Team, Vtammersmith Hospital. RPMS, London, UK /ntroduction: the aim of this study was to assess the degree of aortic valve AV) involvement in heterozygous familial hypercholesterolaemia (FH). Methods: eighty-six patients (pts), 53 males, mean age 524-15 years with ~eterozygous FH had an echocardiographic study. AV was considered as :hickened if there was diffuse thickening > 2 ram. Serum total cholestrerol ITC), triglycerides, HDL-cholesterol, LDL-cholesterol and lipoprotein (a) ~vere asssayed within 1 month of the study. The cholesterol-years score :CYS) for assessing the lifelong exposure to high TC was calculated as follows: TC of each pt at the time of original diagnosis was multiplied by the age of the pt at diagnosis. The mean TC level present in pt while on treatment before the introduction of statins was multiplied by the number of years of non-statin treatment. Finally, the mean TC level while on statin treatment was multiplied by the number of years of statin treatment up to the time of echocardiographic study. The sum of the pre-treatment, non-statin, and statin treatment TC × years scores gave the total CYS. Results: eighteen pts (21%) had thickened AV, but only 2 (2.3%) with severe hypercholesterolaemia (initial TC levels > 17 retool/L, total CYS > t)00 mmol/r × years) had significant aortic stenosis. The table shows the lipids and CYS according to the presence of thickened AV. Seven pts >70 years of whom three had Iocalised AV thickening, were excluded due to the high incidence of degenerative AV thickening in this age. AV thickening

Yes (n = 151

No (n = 641

TC [mrnol/L)

7,44-2.4

6.8~ 1.6

NS

Tnglyccndes

1.5+08

17:t:1 I

NS

LDL cholesterol ((mmoUL)

54:1:2.3

4.8+1.6

NS

HD(. cholesterol

1.2+0.3

[ t 4-0.2

NS

LP(a) [mg/dLI

36.14-2.9

23.54-4.1

NS

CYS (mrnol/L × years)

690+212

4654-133

0,0001

141

ASPECTS OF E N D O T H E L I A L FUNCTION IN VISCERAL OBESITY

E. Jover, Ma.J. Baamonde, A. Martin, A. Mayo, A. Lorenzo, X. Pint61.

/Lipid Unit, University Hospital, Valladolid; Lipid Unit, Belluitge Hospital, Barcelona, Spain In order to evaluate endothelial function in visceral obesity, we have studied the plasma levels of angiotensin-converting enzyme (ACE) in 20 obese men, and those of plasminogen activator inhibitor-I (PAl-I), in 13 of them. We have compared these results, with those obtained in 9 healthy non obese men.

Casuistic was selected, excluding other pathologies as well as ethilic and tabaquic habits, or medicaments consumption. Diagnostic of visceral obesity, was made by using the body mass and waist-hip ratios, and the sagital diameter. Upper limits of some parameters to be included were: fasting blood glucose 110 mg./dL total cholesterol 220 mg./dL and tryglicerides 200 mg./dl. We have also excluded men with familial antecedents for diabetes mellitus. ACE was measured by using molecular absorption spectrometry; the kit ref. 305-10, provided by Sigma Diagnostics was used. PAI-I was measured with an ELISA method. The mean value for ECA in obese, was 0.4325:0.05 microkats./I, versus 0.388+0.018 microcats./I, in controls (p = 0.567). The mean value for PAIl in obese, was 49.91+4.66 ng./ml, and 43.725:5 ng./ml, in controls (p = 0.414). We conclude that ACE and PAl-l, may not show modifications in some patients with visceral obesity, specially, in those who do not show metabolic changes or other type of pathologies, although more studies are required.

p

Immol/L)

(rarno't/L )

Conclusions: the chronic exposure to high TC levels in heterozygous FH induces AV thickening, but rarely result in severe aortic stenosis.

71st EAS Congress and Satellite Symposia