Zhou Qing-Fen, Lu Qiu-Ya, Dai Yang, Chen Qiu-Jing, He Xiao-Shuang, Chen Shuai, Zhao Jun-Tao, Zhang Feng-Ru, Lu Lin, Yang Fan
Department of Cardiovascular Medicine, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Clinical Laboratory, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Cardiovasc Med. 2024 Aug 20;11:1392548. doi: 10.3389/fcvm.2024.1392548. eCollection 2024.
Atrial fibrillation (AF) is a common complication of chronic heart failure (HF). Serum phenylalanine (Phe) levels are related to inflammation disorder. It is meaningful to study the circulating Phe with AF occurrence in HF.
The cross-sectional study recruited 300 patients (78.0% male; mean age, 65 ± 13 years) with HF (left ventricular ejection fraction of ≤50%, containing 70 AF patients) and 100 normal controls. Serum Phe value was measured by liquid chromatography-tandem mass spectrometry. Logistic regression analysis was conducted to measure the association between Phe and AF risk in HF. The association between Phe and high-sensitivity C-reactive protein (hsCRP) was assessed by simple correlation analysis. In the prospective study, the 274 HF subjects (76.6% male; mean age, 65 ± 13 years) were followed up for a mean year (10.99 ± 3.00 months).
Serum Phe levels increased across the control, the HF without AF, and the HF with AF groups (77.60 ± 8.67 umol/L vs. 95.24 ± 28.58 umol/L vs. 102.90 ± 30.43 umol/L, ANOVA < 0.001). Serum Phe value was the independent risk factor for predicting AF in HF [odds ratio (OR), 1.640; 95% CI: 1.150-2.339; = 0.006]. Phe levels were correlated positively with hsCRP value in HF patients with AF ( = 0.577, < 0.001). The elevated Phe levels were associated with a higher risk of HF endpoint events in HF patients with AF (log-rank = 0.005).
In HF with AF subjects, elevated Phe value confers an increased risk for prediction AF and was more related to poor HF endpoint events. Phe can be a valuable index of AF in HF.
心房颤动（AF）是慢性心力衰竭（HF）的常见并发症。血清苯丙氨酸（Phe）水平与炎症紊乱有关。研究HF中循环Phe与AF发生情况具有重要意义。
这项横断面研究纳入了300例HF患者（男性占78.0%；平均年龄65±13岁，左心室射血分数≤50%，其中70例为AF患者）和100例正常对照。采用液相色谱-串联质谱法测定血清Phe值。进行逻辑回归分析以评估Phe与HF中AF风险之间的关联。通过简单相关分析评估Phe与高敏C反应蛋白（hsCRP）之间的关联。在前瞻性研究中，对274例HF受试者（男性占76.6%；平均年龄65±13岁）进行了平均1年（10.99±3.00个月）的随访。
对照组、无AF的HF组和有AF的HF组血清Phe水平依次升高（77.60±8.67μmol/L对95.24±28.58μmol/L对102.90±30.43μmol/L，方差分析P<0.001）。血清Phe值是预测HF中AF的独立危险因素[比值比（OR）为1.640；95%置信区间：1.150 - 2.339；P = 0.006]。在有AF的HF患者中，Phe水平与hsCRP值呈正相关（r = 0.577，P<0.001）。在有AF的HF患者中，Phe水平升高与HF终点事件风险较高相关（对数秩检验P = 0.005）。
在合并AF的HF患者中，升高的Phe值会增加预测AF的风险，并且与不良HF终点事件的相关性更强。Phe可能是HF中AF的一个有价值指标。
