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Apolipoprotein E epsilon4 allele is associated with left ventricular systolic dysfunction.

Abstract

BACKGROUND

Apolipoprotein (APOE) epsilon4 allele has been associated with cardiac dysfunction in Alzheimer's disease and beta-thalassemia. We investigated the association between APOE genotypes and left ventricular dysfunction in a population of community-dwelling elderly subjects.

METHODS

This study was performed in the Rotterdam Study, a population-based prospective cohort study among elderly subjects. For 2206 participants, a baseline echocardiogram and blood specimens for APOE typing were available. Cardiac dysfunction was considered present when fractional shortening was <or=25%. Multivariate logistic regression was used to calculate odds ratios (ORs). The epsilon3/epsilon3 genotype served as a reference category.

RESULTS

In participants who were homozygous for the epsilon4 allele, the odds of cardiac dysfunction was increased 3-fold (OR, 3.1; 95% CI, 1.2-8.1), whereas the odds of cardiac dysfunction in persons with APOE epsilon3/epsilon4 was not significantly increased (OR, 1.5; 95% CI, 0.9-2.5). There was a significant allele-effect relationship for the epsilon4 allele (P-trend <.05). These elevated odds remained after adjustment for cholesterol levels and atherosclerosis parameters. Risks associated with APOE epsilon4/epsilon4 and APOE epsilon3/epsilon4 were more pronounced in participants aged >or=65 years.

CONCLUSION

The APOE epsilon4 allele is an independent risk factor for cardiac dysfunction in elderly people. Besides well-known effects on atherosclerosis and cholesterol levels, there may be other mechanisms, such as apoptosis, through which this allele exerts negative effects on myocardial performance.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, The Netherlands.

    , , , ,

    Source

    American heart journal 147:4 2004 Apr pg 685-9

    MeSH

    Age Factors
    Aged
    Alleles
    Apolipoprotein E3
    Apolipoprotein E4
    Apolipoproteins E
    Case-Control Studies
    Cohort Studies
    Female
    Genotype
    Heart Diseases
    Humans
    Logistic Models
    Male
    Middle Aged
    Multivariate Analysis
    Odds Ratio
    Risk Factors
    Ventricular Dysfunction, Left

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15077085

    Citation

    Bleumink, Gysèle S., et al. "Apolipoprotein E Epsilon4 Allele Is Associated With Left Ventricular Systolic Dysfunction." American Heart Journal, vol. 147, no. 4, 2004, pp. 685-9.
    Bleumink GS, van Duijn CM, Kingma JH, et al. Apolipoprotein E epsilon4 allele is associated with left ventricular systolic dysfunction. Am Heart J. 2004;147(4):685-9.
    Bleumink, G. S., van Duijn, C. M., Kingma, J. H., Witteman, J. C., Hofman, A., & Stricker, B. H. (2004). Apolipoprotein E epsilon4 allele is associated with left ventricular systolic dysfunction. American Heart Journal, 147(4), pp. 685-9.
    Bleumink GS, et al. Apolipoprotein E Epsilon4 Allele Is Associated With Left Ventricular Systolic Dysfunction. Am Heart J. 2004;147(4):685-9. PubMed PMID: 15077085.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Apolipoprotein E epsilon4 allele is associated with left ventricular systolic dysfunction. AU - Bleumink,Gysèle S, AU - van Duijn,Cornelia M, AU - Kingma,J Herre, AU - Witteman,Jacqueline C M, AU - Hofman,Albert, AU - Stricker,Bruno H Ch, PY - 2004/4/13/pubmed PY - 2004/8/10/medline PY - 2004/4/13/entrez SP - 685 EP - 9 JF - American heart journal JO - Am. Heart J. VL - 147 IS - 4 N2 - BACKGROUND: Apolipoprotein (APOE) epsilon4 allele has been associated with cardiac dysfunction in Alzheimer's disease and beta-thalassemia. We investigated the association between APOE genotypes and left ventricular dysfunction in a population of community-dwelling elderly subjects. METHODS: This study was performed in the Rotterdam Study, a population-based prospective cohort study among elderly subjects. For 2206 participants, a baseline echocardiogram and blood specimens for APOE typing were available. Cardiac dysfunction was considered present when fractional shortening was <or=25%. Multivariate logistic regression was used to calculate odds ratios (ORs). The epsilon3/epsilon3 genotype served as a reference category. RESULTS: In participants who were homozygous for the epsilon4 allele, the odds of cardiac dysfunction was increased 3-fold (OR, 3.1; 95% CI, 1.2-8.1), whereas the odds of cardiac dysfunction in persons with APOE epsilon3/epsilon4 was not significantly increased (OR, 1.5; 95% CI, 0.9-2.5). There was a significant allele-effect relationship for the epsilon4 allele (P-trend <.05). These elevated odds remained after adjustment for cholesterol levels and atherosclerosis parameters. Risks associated with APOE epsilon4/epsilon4 and APOE epsilon3/epsilon4 were more pronounced in participants aged >or=65 years. CONCLUSION: The APOE epsilon4 allele is an independent risk factor for cardiac dysfunction in elderly people. Besides well-known effects on atherosclerosis and cholesterol levels, there may be other mechanisms, such as apoptosis, through which this allele exerts negative effects on myocardial performance. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/15077085/Apolipoprotein_E_epsilon4_allele_is_associated_with_left_ventricular_systolic_dysfunction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002870303008354 DB - PRIME DP - Unbound Medicine ER -