Abstract:
BACKGROUND:Trimethylamine N-oxide (TMAO), a gut-related metabolite, is associated with heart failure (HF) outcomes. However, TMAO is the final product of a complex metabolic pathway (ie, choline/carnitine) that has never been entirely investigated in HF. The present study investigates a panel of metabolites involved in the TMAO-choline/carnitine metabolic pathway for their associations with outcome in acute HF patients. METHODS:In total, 806 plasma samples from acute HF patients were analyzed for TMAO, trimethyllysine, L-carnitine, acetyl-L-carnitine, γ-butyrobetaine, crotonobetaine, trimethylamine, betaine aldehyde, choline, and betaine using a developed liquid chromatography-tandem mass spectrometry method. Associations with outcome of all-cause mortality (death) and a composite of all-cause mortality and/or rehospitalization caused by HF (death/HF) at 30 days and 1 year were investigated. RESULTS:TMAO, trimethyllysine, L-carnitine, acetyl-L-carnitine, and γ-butyrobetaine were associated with death and death/HF at 30 days (short term; hazard ratio 1.30-1.49, P≤ .021) and at 1 year (long term; hazard ratio 1.15-1.25, P≤ .026) when adjusted for cardiac risk factors. L-carnitine and acetyl-L-carnitine were superior for short-term outcomes whereas TMAO was the superior metabolite for association with long-term outcomes. Furthermore, acetyl-L-carnitine and L-carnitine were superior for in-hospital mortality and improved risk stratification when combined with current clinical risk scores (ie, Acute Decompensated HEart Failure National REgistry, Organized Program To Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure, and Get With The Guidelines-Heart Failure; odds ratio (OR) ≥ 1.52, P≤ .020). CONCLUSIONS:Carnitine-related metabolites show associations with adverse outcomes in acute HF, in particular L-carnitine and acetyl-L-carnitine for short-term outcomes, and TMAO for long-term outcomes. Further studies are warranted to investigate the role and implications of carnitine metabolites including intervention in the pathogenesis of HF.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Israr MZ,Bernieh D,Salzano A,Cassambai S,Yazaki Y,Heaney LM,Jones DJL,Ng LL,Suzuki Tdoi
10.1016/j.ahj.2021.01.006subject
Has Abstractpub_date
2021-01-14 00:00:00pages
71-80eissn
0002-8703issn
1097-6744pii
S0002-8703(21)00010-7journal_volume
234pub_type
杂志文章abstract:BACKGROUND:Percutaneous pulmonary valve implantation (PPVI) has been introduced as therapy for right ventricular (RV) to pulmonary artery conduit dysfunction in patients with congenital heart disease. It has been shown that RV systolic function improved early after PPVI. The effects of PPVI on RV diastolic function and...
journal_title:American heart journal
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abstract::Implantable cardioverter defibrillators (ICDs) are now widely used for the secondary prevention of sudden cardiac death and are being offered as a primary preventive therapy. This technology has potential for significant fiscal impact on health care budgets. Technologic innovation will result in more complex devices t...
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doi:10.1016/0002-8703(94)90109-0
更新日期:1994-04-01 00:00:00
abstract::We evaluated electrocardiographically the acute effect of captopril in the initial treatment of malignant or severe hypertension and the findings were compared with the data obtained with diazoxide. The captopril group included seven patients treated with captopril or with a combination of diuretics. The diazoxide gro...
journal_title:American heart journal
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更新日期:1998-04-01 00:00:00
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更新日期:2005-02-01 00:00:00
abstract::The hearts from 10 necropsy patients with Ebstein's anomaly of the tricuspid valve were examined for abnormalities of the mitral valve. Five patients were under 1 year of age and none had an abnormal mitral valve. The other five patients were ages 18 to 72 years (mean 36 years); all had focal fibrous thickening of the...
journal_title:American heart journal
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更新日期:2013-08-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2002-12-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章
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更新日期:2016-04-01 00:00:00
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pub_type: 信件,meta分析
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更新日期:2020-09-01 00:00:00
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更新日期:2009-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:1990-06-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1999-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1989-11-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2000-04-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章
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