Low LDL Levels are Associated with the Absence of Dyspnea in Patients with Chronic Heart Failure

Objective — The goal of our study was to identify biochemical criteria among those most commonly used in general clinical practice for dyspnea in chronic heart failure (CHF). Methods — The study included 594 patients with confirmed CHF. We measured biochemical parameters (levels of creatinine, glucose, low-density lipoprotein [LDL], and C-reactive protein [CRP]) and performed the six-minute walk test (6MWT) before and after disease-modifying therapy (DMT) over the period of 12 months: angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor-neprilysin inhibitors (ARNIs), beta blockers, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter-2 (SGLT2) inhibitors. The association of biochemical markers with the presence of dyspnea in patients with CHF was evaluated through correlation analysis and a decision tree. Results — We established that the most closely associated biochemical maker with dyspnea in patients with CHF is the LDL level with cutoff values of 3.245 and 3.266 mmol/L before and after DMT, respectively. High specificity of LDL was demonstrated for recognizing the absence of dyspnea, but critically low sensitivity for the presence Shortness of breath. Conclusion — Low LDL level is associated with an absence of dyspnea in patients with CHF against the background of DMT.