Nguyen B O, Meems L M G, van Faassen M, Crijns H J G M, van Gelder I C, Kuipers F, Rienstra M
Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Int J Cardiol Heart Vasc. 2021 May 24;34:100798. doi: 10.1016/j.ijcha.2021.100798. eCollection 2021 Jun.
The importance of gut microbiome in cardiovascular disease has been increasingly recognized. Trimethylamine N-oxide (TMAO) is a gut microbe-derived metabolite that is associated with cardiovascular disease, including atrial fibrillation (AF). The role of TMAO in clinical AF progression however remains unknown.
In this study we measured TMAO and its precursor (betaine, choline, and L- carnitine) levels in 78 patients using plasma samples from patients that participated in the AF-RISK study. 56 patients suffered from paroxysmal AF and 22 had a short history of persistent AF. TMAO levels were significantly higher in patients with persistent AF, as compared to those with paroxysmal AF (median [IQR] 5.65 [4.7-9.6] / versus 4.31 [3.2-6.2] /, p < 0.05), while precursor levels did not differ. In univariate analysis, we observed that for every unit increase in TMAO, the odds for having persistent AF increased with 0.44 [0.14-0.73], p < 0.01. Conclusion: These results suggest that higher levels of TMAO are associated with more progressed forms of AF. We therefore hypothesize that increased TMAO levels may reflect disease progression in humans. Larger studies are required to validate these preliminary findings. Clinicaltrials.gov NCT01510210.
肠道微生物群在心血管疾病中的重要性已得到越来越多的认可。氧化三甲胺（TMAO）是一种源自肠道微生物的代谢产物，与心血管疾病相关，包括心房颤动（AF）。然而，TMAO在临床房颤进展中的作用仍不清楚。
在本研究中，我们使用参与AF-RISK研究患者的血浆样本，测量了78例患者的TMAO及其前体（甜菜碱、胆碱和左旋肉碱）水平。56例患者患有阵发性房颤，22例有短暂的持续性房颤病史。与阵发性房颤患者相比，持续性房颤患者的TMAO水平显著更高（中位数[四分位间距]5.65[4.7 - 9.6]/对4.31[3.2 - 6.2]/，p < 0.05），而前体水平无差异。在单变量分析中，我们观察到TMAO每增加一个单位，发生持续性房颤的几率增加0.44[0.14 - 0.73]，p < 0.01。结论：这些结果表明，较高水平的TMAO与更严重形式的房颤相关。因此，我们假设TMAO水平升高可能反映人类疾病进展。需要更大规模的研究来验证这些初步发现。Clinicaltrials.gov NCT01510210。
