Shingu Yasushige, Yokota Isao, Kato Tatsuya, Hida Yasuhiro, Kaga Kichizo, Gao Jingwen, Wakasa Satoru
Department of Cardiovascular Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.
J Clin Med. 2024 Oct 18;13(20):6228. doi: 10.3390/jcm13206228.
L-carnitine is essential in lipid metabolism and reportedly has preventive effects for arrhythmia. Our objective was to examine the incidence of postoperative atrial fibrillation (POAF) and changes in serum biomarker levels following perioperative L-carnitine administration in patients with lung cancer. Thirteen patients undergoing a lobectomy with preoperative serum brain natriuretic peptide levels >24 pg/mL were perioperatively administered L-carnitine for 5 days (3 g/3×). Accurate 95% confidence intervals (CI) for POAF incidence were calculated. Serum biomarkers for POAF in lung cancer and target proteins for L-carnitine were evaluated by using open-source data from proteomic analysis. The incidence of POAF was 38.5% (95% CI 13.9%-68.4%). Fatty acid-binding protein 4 (FABP4) was selected as a candidate biomarker from 1472, 63, and 26 proteins related to lung cancer, L-carnitine, and AF, respectively. A positive correlation was observed between the predicted POAF incidence rate and preoperative FABP4 levels (Pearson's r = 0.5183). The mean change in serum FABP4 after L-carnitine administration for 5 days was -2.9 ng/mL (95% CI -4.9 to -0.89 ng/mL). The incidence of POAF after a lobectomy was 38.5% after the perioperative administration of L-carnitine for patients at a high risk of POAF. The serum FABP4 level demonstrates potential as a candidate biomarker for POAF prediction.
左旋肉碱在脂质代谢中必不可少，据报道对心律失常有预防作用。我们的目的是研究围手术期给予肺癌患者左旋肉碱后术后房颤（POAF）的发生率及血清生物标志物水平的变化。13例术前血清脑钠肽水平>24 pg/mL且接受肺叶切除术的患者在围手术期接受左旋肉碱治疗5天（3 g/3次）。计算POAF发生率的准确95%置信区间（CI）。通过蛋白质组学分析的开源数据评估肺癌中POAF的血清生物标志物和左旋肉碱的靶蛋白。POAF的发生率为38.5%（95%CI 13.9%-68.4%）。分别从与肺癌、左旋肉碱和房颤相关的1472、63和26种蛋白质中选择脂肪酸结合蛋白4（FABP4）作为候选生物标志物。观察到预测的POAF发生率与术前FABP4水平之间呈正相关（Pearson相关系数r = 0.5183）。左旋肉碱给药5天后血清FABP4的平均变化为-2.9 ng/mL（95%CI -4.9至-0.89 ng/mL）。对于POAF高危患者，围手术期给予左旋肉碱后肺叶切除术后POAF的发生率为38.5%。血清FABP4水平显示出作为POAF预测候选生物标志物的潜力。
