介入左心耳封堵术影响酰基辅酶 A 的代谢。

Interventional Left Atrial Appendage Closure Affects the Metabolism of Acylcarnitines.

机构信息

First Department of Medicine, University Medical Center Mannheim, Faculty of Medicine Mannheim, University of Heidelberg, 68167 Mannheim, Germany.

Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, 79189 Bad Krozingen, Germany.

出版信息

Int J Mol Sci. 2018 Feb 7;19(2):500. doi: 10.3390/ijms19020500.

DOI:10.3390/ijms19020500

PMID:29414920

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5855722/

Abstract

BACKGROUND

Left atrial appendage closure (LAAC) represents the interventional alternative to oral anticoagulation for stroke prevention in atrial fibrillation (AF). The metabolism of acylcarnitines was shown to affect cardiovascular diseases. This study evaluates the influence of successful LAAC on the metabolism of acylcarnitines.

METHODS

Patients undergoing successful LAAC were enrolled prospectively. Peripheral blood samples for metabolomics measurements were collected immediately before (i.e., index) and six months after LAAC (i.e., mid-term). A targeted metabolomics analysis based on electrospray ionization-liquid chromatography-mass spectrometry (ESI-LC-MS/MS) and MS/MS measurements was performed.

RESULTS

44 patients with non-valvular AF (median CHA₂DS₂-VASc score 4, median HAS-BLED score 4) and successful LAAC were included. Significant changes in acylcarnitine levels were found in the total cohort, which were mainly attributed to patients with impaired left ventricular and renal function, elevated amino-terminal pro-brain natriuretic peptide (NT-proBNP) and diabetes mellitus. Adjusted multivariable regression models revealed significant changes of five metabolites over mid-term follow-up: C2, C14:1, C16, and C18:1 decreased significantly (each < 0.05); short-chain C5 acylcarnitine plasma levels increased significantly ( < 0.05).

CONCLUSION

This study demonstrates that successful LAAC affects the metabolism of acylcarnitines at mid-term follow-up.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02985463.

摘要

背景

左心耳封堵术（LAAC）代表了在房颤（AF）中预防中风的口服抗凝替代方法。酰基辅酶 A 的代谢被证明会影响心血管疾病。本研究评估了 LAAC 成功对酰基辅酶 A 代谢的影响。

方法

前瞻性纳入接受成功 LAAC 的患者。在 LAAC 前（即指数）和六个月后（即中期）采集用于代谢组学测量的外周血样本。进行基于电喷雾电离-液相色谱-质谱联用（ESI-LC-MS/MS）和 MS/MS 测量的靶向代谢组学分析。

结果

共纳入 44 例非瓣膜性 AF 患者（中位数 CHA₂DS₂-VASc 评分为 4，中位数 HAS-BLED 评分为 4）和成功 LAAC。在总队列中发现酰基辅酶 A 水平发生了显著变化，这主要归因于左心室和肾功能受损、氨基末端脑钠肽前体（NT-proBNP）升高和糖尿病患者。调整后的多变量回归模型显示，中期随访中有 5 种代谢物发生了显著变化：C2、C14:1、C16 和 C18:1 显著降低（均<0.05）；短链 C5 酰基辅酶 A 血浆水平显著升高（<0.05）。