Documento de consenso de un grupo de expertos de la Sociedad Española de Arteriosclerosis (SEA) sobre el uso clínico de la resonancia magnética nuclear en el estudio del metabolismo lipoproteico (Liposcale)

  1. Pintó, Xavier
  2. Masana, Luis
  3. Civeira, Fernando
  4. Real, José 1
  5. Ibarretxe, Daiana
  6. Candas, Beatriz 2
  7. Puzo, José
  8. Díaz, José Luis 3
  9. Amigó, Núria
  10. Esteban, Margarita
  11. Valdivielso, Pedro
  1. 1 Servicio Endocrinología, CIBERDEM. Hospital Clínico Universitario de Valencia, Universidad de Valencia, Valencia, España
  2. 2 Bioquímica Especial y Biología Molecular, Laboratori Clínic. Hospital Universitario de Bellvitge, Barcelona, España
  3. 3 Unidad de Lípidos y Riesgo Cardiovascular, Servicio de Medicina Interna, Complejo Hospitalario Universitario de A Coruña, A Coruña, España
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Revista:
Clínica e investigación en arteriosclerosis

ISSN: 0214-9168,  1578-1879

Año de publicación: 2020

Volumen: 32

Número: 5

Páginas: 219-229

Tipo: Artículo

DOI: 10.1016/J.ARTERI.2020.04.004 PMID: 32798078 SCOPUS: 2-s2.0-85089298637 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Clínica e investigación en arteriosclerosis

Resumen

The assessment and prevention of cardiovascular risk (CVR) that persists in patients with dyslipidaemia despite treatment and achievement of goals specific to the plasma concentration of cholesterol linked to low density (c-LDL) is a clinical challenge today, and suggests that conventional lipid biomarkers are insufficient for an accurate assessment of CVR. Apart from their lipid content, there are other lipid particle characteristics. The results of this study show that there are a number of lipoprotein compounds that determine atherogenic potential and its influence on the CVR. However, such additional characteristics cannot be analysed by the techniques commonly used in clinical laboratories. Nuclear Magnetic Resonance (NMR) is a technique that allows a detailed analysis to be made of the amount, composition, and size of lipoproteins, as well as providing more information about the detailed status of lipid metabolism and CVR in dyslipidaemia patients. In this article a group of lipidologists from the Spanish Society of Arteriosclerosis review the existing evidence on the atherogenic mechanisms of particles and describe the technical basis and interpretation of the profiles lipoproteins obtained by MRI, with special reference to the test available in Spain (Liposcale®). Likewise, the main patient profiles are defined as such that an analysis would provide information of greater clinical interest. These include: a) Suspected mismatch between lipid concentrations and particles, a common situation in diabetes, obesity, metabolic syndrome; b) Early atherothrombotic cardiovascular disease (ECVA) or recurrent without CVR factors to justify it; c) Lipid disorders, rare or complex, such as extreme concentrations of c-HDL, and d) Clinical situations where classical analytical techniques cannot be applied, such as very low c-LDL values.

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