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: HTTPS://DOI.ORG/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

La evaluación y prevención del riesgo cardiovascular (RCV) que persiste en los pacientes con dislipidemia a pesar del tratamiento y de haber alcanzado los objetivos específicos de la concentración plasmática de colesterol unido a lipoproteínas de baja densidad (c-LDL) es un reto clínico en la actualidad, y sugiere que los biomarcadores lipídicos convencionales resultan insuficientes para una evaluación precisa del RCV. Más allá de su contenido lipídico, existen otras características propias de las partículas lipoproteicas que determinan su potencial aterogénico y su influencia en el RCV. Sin embargo, dichas características adicionales no pueden ser analizadas por las técnicas utilizadas habitualmente en los laboratorios clínicos. La espectroscopia por resonancia magnética nuclear (RMN) es una técnica que permite un análisis detallado de la cantidad, composición y tamaño de las lipoproteínas y proporciona información más detallada del estado del metabolismo lipídico y del RCV en los pacientes dislipémicos. En este artículo un grupo de lipidólogos de la Sociedad Española de Arteriosclerosis revisa la evidencia existente sobre los mecanismos aterogénicos de las partículas lipoproteicas y describen el fundamento técnico y la interpretación de los perfiles lipoproteicos obtenidos mediante RMN, haciendo especial referencia al test disponible en España (Liposcale®). Asimismo, se definen los principales perfiles de pacientes en los que dicho análisis aportaría una información de mayor interés clínico, los cuales son: a) sospecha de discordancia entre las concentraciones de lípidos y el número de partículas, situación frecuente en la diabetes, la obesidad, el síndrome metabólico y la hipertrigliceridemia; b) enfermedad cardiovascular aterotrombótica (ECVA) precoz o recurrente sin factores de RCV que la justifiquen; c) trastornos lipídicos infrecuentes o complejos como las concentraciones extremas de c-HDL, y d) situaciones clínicas en las que las técnicas analíticas clásicas no pueden aplicarse, como los valores de c-LDL muy bajos.

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