First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.
DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany.
Sci Rep. 2018 Apr 12;8(1):5894. doi: 10.1038/s41598-018-23935-w.
Patients with non-valvular atrial fibrillation (AF) and a high risk for oral anticoagulation can be treated by percutaneous implantation of left atrial appendage occlusion devices (LAAC) to reduce the risk of cardio-embolic stroke. This study evaluates whether LAAC may influence lipid metabolism, which has never been investigated before. Patients with successful LAAC were included consecutively. Venous peripheral blood samples of patients were collected immediately before (T0, baseline) and 6 months after (T1, mid-term) LAAC. A targeted metabolomics approach based on electrospray ionization liquid chromatography-mass spectrometry (ESI-LC-MS/MS) and MS/MS measurements was performed. A total of 34 lipids revealed a significant change from baseline to mid-term follow-up after successful LAAC. Subgroup analysis revealed confounding influence by gender, age, diabetes mellitus type II, body mass index, left ventricular ejection fraction, creatinine and NT-proBNP. After multivariable adjustment within logistic regression models, these 34 lipids were still significantly altered after LAAC. Successful percutaneous LAAC may affect lipid metabolism and thereby may potentially affect pro-atherogenic and cardio-toxic effects.
患有非瓣膜性心房颤动 (AF) 且抗凝治疗风险较高的患者，可通过经皮左心耳封堵装置 (LAAC) 植入来降低心源性卒中的风险。本研究评估了 LAAC 是否会影响脂质代谢，而这一点以前从未被研究过。连续纳入成功进行 LAAC 的患者。在 LAAC 前（T0，基线）和 6 个月后（T1，中期）立即采集患者的静脉外周血样本。采用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方法进行分析。成功进行 LAAC 后，从基线到中期随访，共有 34 种脂质发生了显著变化。亚组分析显示，性别、年龄、2 型糖尿病、体重指数、左心室射血分数、肌酐和 NT-proBNP 对这些变化有混杂影响。在逻辑回归模型中进行多变量调整后，LAAC 后这些脂质仍明显改变。成功的经皮 LAAC 可能会影响脂质代谢，从而可能潜在地影响动脉粥样硬化形成和心脏毒性作用。
