介入左心耳封堵术可能影响必需氨基酸代谢和生物能量功效。

Interventional left atrial appendage closure may affect metabolism of essential amino acids and bioenergetic efficacy.

机构信息

First Department of Medicine, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS) and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany.

出版信息

Int J Cardiol. 2018 Oct 1;268:125-131. doi: 10.1016/j.ijcard.2018.05.031. Epub 2018 Jun 1.

DOI:10.1016/j.ijcard.2018.05.031

PMID:29861102

Abstract

BACKGROUND

Interventional closure of left atrial appendage (LAAC) represents an alternative for stroke prevention in patients with non-valvular atrial fibrillation. Whether LAAC may affect metabolomic pathways has not been investigated yet. This study evaluates the impact of LAAC on the metabolism of essential amino acids, kynurenine and creatinine.

METHODS

Peripheral blood samples of prospectively enrolled patients undergoing successful LAAC were taken before (T0) and 6 months after (T1, mid-term follow-up). Targeted metabolomic profiling was performed using electrospray ionization liquid chromatography-mass spectrometry (ESI-LC-MS/MS) and MS/MS measurements focusing on metabolism of essential amino acids.

RESULTS

44 patients with non-valvular AF (mean CHA2DS2-VASc score 4, mean HAS-BLED score 4) were enrolled. Changes in metabolites of essential amino acids, myocardial contraction and bioenergetic efficacy, such as phenylalanine (percentage change 8.2%, p = 0.006), tryptophan (percentage change 20.3%, p = 0.0006), tyrosine (percentage change 20.2%, p = 0.0001), creatinine (percentage change 7.2%, p > 0.05) and kynurenine (percentage change 8.3%, p = 0.0239) were found at mid-term follow-up.

CONCLUSIONS

LAAC may affect the metabolism of essential amino acids and bioenergetic efficacy. ClinicalTrials.gov Identifier: NCT02985463.

摘要

背景

介入性左心耳封堵术（LAAC）代表了一种预防非瓣膜性心房颤动患者中风的替代方法。LAAC 是否会影响代谢途径尚未得到研究。本研究评估了 LAAC 对必需氨基酸、犬尿氨酸和肌酸代谢的影响。

方法

前瞻性纳入的成功接受 LAAC 的患者在术前（T0）和术后 6 个月（T1，中期随访）采集外周血样本。使用电喷雾电离液相色谱-质谱联用（ESI-LC-MS/MS）和 MS/MS 测量进行靶向代谢组学分析，重点关注必需氨基酸的代谢。

结果

共纳入 44 例非瓣膜性 AF 患者（平均 CHA2DS2-VASc 评分 4 分，平均 HAS-BLED 评分 4 分）。必需氨基酸代谢物、心肌收缩和生物能量效率的变化，如苯丙氨酸（百分比变化 8.2%，p=0.006）、色氨酸（百分比变化 20.3%，p=0.0006）、酪氨酸（百分比变化 20.2%，p=0.0001）、肌酸（百分比变化 7.2%，p>0.05）和犬尿氨酸（百分比变化 8.3%，p=0.0239）在中期随访时发现。