Mechanisms
Elevated Lp(a) tracks with cardiac MRI signs of myocardial fibrosis in group II pulmonary hypertension from HFpEF (Future Cardiol 2025)
Original title: Elevated Lp(a) and its association with cardiac fibrosis in group II pulmonary hypertension patients
In a retrospective cohort of 100 patients with group II pulmonary hypertension secondary to heart failure with preserved ejection fraction, elevated serum Lp(a) was significantly associated with greater myocardial extracellular volume on cardiac MRI (31% vs. 27%, p < 0.01), prolonged native T1 times, and higher odds of myocardial scar formation on late gadolinium enhancement, after adjustment for confounders. Structural cardiac changes correlated with Lp(a) concentration. The authors propose Lp(a) as a marker of myocardial fibrosis and remodelling in this population, suggesting routine measurement could aid risk stratification, though the single-centre retrospective design limits causal inference.
Original abstract
Background: Group II Pulmonary Hypertension (PH) secondary to Heart Failure with preserved Ejection Fraction (HFpEF) is associated with significant morbidity and mortality. Lipoprotein(a) [Lp(a)] is a novel biomarker implicated in cardiovascular pathology, yet its role in myocardial fibrosis within this population remains underexplored. This study investigates the association between elevated Lp(a) levels and cardiac fibrosis to improve understanding of its prognostic and diagnostic utility.
Methods: This retrospective cohort study included 100 patients with Group II PH secondary to HFpEF. Serum Lp(a) levels were quantified using enzymatic assays, and myocardial fibrosis was assessed using Cardiac Magnetic Resonance Imaging (CMR) techniques, including T1 mapping and late gadolinium enhancement (LGE). Statistical models adjusted for confounding factors.
Results: Elevated Lp(a) levels were significantly associated with increased myocardial extracellular volume (31% vs. 27%, p < 0.01), prolonged native T1 times, and increased odds of myocardial scar formation. Structural cardiac changes correlated with Lp(a) concentrations.
Conclusion: Elevated Lp(a) is a key marker of myocardial fibrosis and structural remodeling in Group II PH secondary to HFpEF. Routine Lp(a) measurement may enhance risk stratification and inform therapeutic strategies.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.