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BackgroundApolipoprotein (APOE) epsilon4 allele has been associated with cardiac dysfunction in Alzheimer's disease and beta-thalassemia. We investigated the association between APOE genotypes and left ventricular dysfunction in a population of community-dwelling elderly subjects.MethodsThis study was performed in the Rotterdam Study, a population-based prospective cohort study among elderly subjects. For 2206 participants, a baseline echocardiogram and blood specimens for APOE typing were available. Cardiac dysfunction was considered present when fractional shortening was ResultsIn participants who were homozygous for the epsilon4 allele, the odds of cardiac dysfunction was increased 3-fold (OR, 3.1; 95% CI, 1.2-8.1), whereas the odds of cardiac dysfunction in persons with APOE epsilon3/epsilon4 was not significantly increased (OR, 1.5; 95% CI, 0.9-2.5). There was a significant allele-effect relationship for the epsilon4 allele (P-trend or=65 years.ConclusionThe APOE epsilon4 allele is an independent risk factor for cardiac dysfunction in elderly people. Besides well-known effects on atherosclerosis and cholesterol levels, there may be other mechanisms, such as apoptosis, through which this allele exerts negative effects on myocardial performance.

Original publication




Journal article


American heart journal

Publication Date





685 - 689


Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, The Netherlands.


Humans, Heart Diseases, Ventricular Dysfunction, Left, Apolipoproteins E, Multivariate Analysis, Logistic Models, Odds Ratio, Risk Factors, Case-Control Studies, Cohort Studies, Age Factors, Genotype, Alleles, Aged, Middle Aged, Female, Male, Apolipoprotein E3, Apolipoprotein E4