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Abstract
Accelerated atherosclerosis is a major complication of heart transplantation, and
is frequently associated with a dyslipoproteinemia characterized by a paradoxical
increase in HDL-cholesterol concentration. To define this abnormality, the lipoprotein
profiles of 25 heart transplant recipients (HTR) were analyzed and compared with those
of 26 control subjects. HDL, as separated on the basis of density in 3 subfractions,
were increased in concentration: HDLz: +51%, HDL3a: +29%, HDL3b: +32%. HDL2 and HDL3a displayed an enrichment in surface components, phospholipids, unesterified cholesterol
and apo E, leading to an increased size compared with subfractions of similar density
in the controls. The major steps of plasma HDL metabolism were investigated: cholesterol
esterification (LCAT activity), cholesteryl ester transfer to apo B-containing lipoproteins
(CETP) and the hepatic hydrolysis of HDL components (HL activity). We demonstrated
a partial deficiency in CETP (-28%) and hepatic lipase (-36%) activities with normal
LCAT activity. Correlations in total study population (HTR plus controls) evidenced
negative associations between CETP activity and HDL3a concentrations and between HL activity and HDL2-cholesterol as a percent of total HDL-cholesterol. Therapeutic agents used in post
transplantation treatment such as glucocorticoids and/or cyclosporine may be speculated
thus to affect both CETP and HL activities and, by arresting the HDL cycle in a CE-saturated
state, to decrease the efficiency of reverse cholesterol extraction at the site of
the graft.
Keywords
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Article info
Publication history
Accepted:
May 20,
1993
Received in revised form:
April 15,
1993
Received:
July 28,
1992
Identification
Copyright
© 1993 Elsevier Scientific Publishers Ireland Ltd. All rights reserved. Published by Elsevier Inc.
