Studies on subjects with and without coronary heart disease. Serum lipid, lipoprotein, and protein determinations and their relation to ballistocardiographic findings (a preliminary survey)

Abstract

1. 1. Biochemical and ballistocardiographic studies were carried out on 115 ambulatory patients with coronary heart disease (angina pectoris, old myocardial infarction, or both) and 165 clinically normal subjects. Biochemical studies included determinations of total cholesterol, and paper electrophoretic studies of serum proteins and lipoproteins. Electrophoretic patterns were compared with simultaneously run patterns from pooled normal serum, and the departures from normal were graded as to concentration and migration rate. Ballistocardiograms were of the Starr type and were classified as normal, borderline, and abnormal. 2. 2. Mean serum cholesterol in the normal group rose progressively from age 20 to a maximum in the seventh decade, after which it fell. Cholesterol values were significantly higher in patients with coronary heart disease, but there was an age trend which resembled that in normal subjects. 3. 3. The most significant changes in the protein and lipoprotein electrophoretic patterns were increased beta lipoprotein and increased and/or retarded alpha-2 protein. These alterations were treated separately and then combined as abnormalities of beta lipoprotein, alpha-2 protein, or both. In normal individuals these abnormalities increased in frequency with age, and in the sixth to eighth decades, one or more lipid-protein abnormalities were present in about 50 per cent of the subjects. In patients with coronary disease there was a suggestive age trend, though less marked than in normal subjects. The lipid-protein abnormalities in these patients were considerably more frequent than in the normal subjects especially over the age range from 30 to 59 years. 4. 4. The ballistocardiogram was normal in all clinically normal persons under 40, but thereafter abnormal records occurred with increasing frequency to a maximum of 100 per cent in the eighth decade. Abnormal ballistocardiograms were more frequent in patients with coronary disease, but a similar age trend was observed. 5. 5. Aside from their mutual relationship to age, no association could be found between serum cholesterol level and ballistocardiographic classification in normal individuals. Among patients with coronary disease, only in those from 30 to 49 years of age was mean serum cholesterol significantly higher in subjects with abnormal ballistocardiograms than in those with normal records. Lipoprotein and protein electrophoretic abnormalities were more frequent in normal subjects and young patients (30 to 49 years) with coronary heart disease whose ballistocardiograms were abnormal than in those whose records were normal. 6. 6. The results of this study suggest that further exploration of the relationship between changes in serum lipid proteins and circulatory function may be rewarding.