Reconstituted high-density lipoprotein shortens cardiac repolarization

Abstract

Objectives: We hypothesize that increasing high-density lipoprotein cholesterol (HDL-C) shortens cardiac repolarization.

Background: HDL-C is inversely associated with sudden death. The relation between HDL-C and repolarization of the heart is unexplored.

Methods: HDL-C was elevated with reconstituted high-density lipoprotein (rHDL). Cardiac repolarization was studied by recording cardiac transmembrane potentials with the patch clamp technique from isolated rabbit cardiomyocytes that were superfused with rHDL. Infusions with rHDL (40 mg/kg body weight) were performed in dyslipidemic patients and healthy volunteers. Electrocardiograms were recorded to assess cardiac repolarization before and 24 h after infusion with rHDL.

Results: rHDL as well as purified human apolipoprotein AI shortened repolarization of isolated rabbit cardiomyocytes by ∼25% (p < 0.05). rHDL infusion shortened the heart rate-corrected QT interval on surface electrocardiograms in all participants (p < 0.001).

Conclusions: rHDL shortens cardiac repolarization. These data provide evidence for a novel mechanism of HDL infusion that may contribute to reduction of sudden cardiac death.