Wang Huiqing, Wu Junfang, Wei Haoran, Zhang Yuxuan, Wang Yinhui, Wang Dao Wen
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China.
Inflammation. 2025 Apr;48(2):963-973. doi: 10.1007/s10753-024-02100-8. Epub 2024 Jul 16.
Kynurenine to tryptophan ratio (KTR), which serves as an indicator for evaluating indoleamine-2,3-dioxygenase activity and inflammation, has been reported to be linked with cardiovascular incidences. However, its correlation with cardiovascular outcomes in patients suffering from heart failure (HF) remains to be explored. The objective of this study was to investigate the prognostic value of KTR in HF. The concentration of tryptophan and kynurenine were quantified by liquid chromatography-tandem mass spectrometry, and the KTR value was calculated in a population of 3150 HF patients. The correlation between plasma KTR levels and the occurrence of adverse cardiovascular events was evaluated for its prognostic value. We also assessed the role of KTR in addition to the classic inflammatory biomarker hypersensitive C-reactive protein (hs-CRP) in different subtypes of HF. We found that increased KTR levels were associated with an elevated risk and severity of the primary endpoints in different subtypes of HF. The simultaneous evaluation of KTR and hs-CRP levels enhanced risk categorization among HF patients. Furthermore, the KTR index presented complementary prognostic value for those HF patients with low-grade inflammation (hs-CRP ≤ 6 mg/L). Our results indicated plasma KTR is an independent risk factor for cardiovascular events. Plasma KTR levels in patients with HF can provide both concurrent and complementary prognostic value to hs-CRP.
犬尿氨酸与色氨酸比值（KTR）作为评估吲哚胺-2,3-双加氧酶活性和炎症的指标，据报道与心血管疾病的发生率有关。然而，其与心力衰竭（HF）患者心血管结局的相关性仍有待探索。本研究的目的是探讨KTR在HF中的预后价值。采用液相色谱-串联质谱法定量色氨酸和犬尿氨酸的浓度，并计算3150例HF患者群体的KTR值。评估血浆KTR水平与不良心血管事件发生之间的相关性以确定其预后价值。我们还评估了KTR在除经典炎症生物标志物超敏C反应蛋白（hs-CRP）之外，在不同亚型HF中的作用。我们发现，KTR水平升高与不同亚型HF中主要终点事件的风险增加和严重程度相关。同时评估KTR和hs-CRP水平可增强HF患者的风险分层。此外，KTR指数对那些低度炎症（hs-CRP≤6mg/L）的HF患者具有补充预后价值。我们的结果表明血浆KTR是心血管事件的独立危险因素。HF患者的血浆KTR水平可为hs-CRP提供同时和补充的预后价值。
