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.

Additional Metadata
Keywords 0 (Apolipoproteins E), 0 (apolipoprotein E-3), 0 (apolipoprotein E-4), Age Factors, Aged, Alleles, Apolipoproteins E/*genetics, Case-Control Studies, Cohort Studies, Female, Genotype, Heart Diseases/genetics, Human, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Risk Factors, Support, Non-U.S. Gov't, Ventricular Dysfunction, Left/*genetics, atherosclerosis, stroke
Persistent URL dx.doi.org/10.1016/j.ahj.2003.11.016, hdl.handle.net/1765/5986
Citation
Bleumink, G.S., van Duijn, C.M., Kingma, J.H., Hofman, A., Witteman, J.C.M., & Stricker, B.H.Ch.. (2004). Apolipoprotein E ε4 allele is associated with left ventricular systolic dysfunction. American Heart Journal, 147(4), 685–689. doi:10.1016/j.ahj.2003.11.016