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Heart:红肉摄入或与急性心力衰竭患者预后较差相关

来源:生物谷 2016-02-22 13:32

图片来源:www.ecorazzi.com

2016年2月22日 讯 /生物谷BIOON/ --来自莱斯特大学的科学家近日在Heart杂志上刊登了他们的最新研究成果,研究人员发现,急性心力衰竭的患者机体中通常含有较高水平的代谢产物氧化三甲胺(Trimethylamine-N-oxide,TMAO),而红肉是这种代谢产物的主要来源。

有研究报道红肉和心血管疾病发病直接相关,而且红肉也是左旋肉碱(L-Carnitine)的一个主要来源,左旋肉碱在机体中会被肠道细菌所分解形成TMAO。此前研究中,TMAO被认为和慢性心力衰竭患者的死亡风险直接相关,但在急性心力衰竭患者中这种关联目前研究者并未证实。

文章中研究人员对因急性心力衰竭住院的将近1000名患者机体中循环的TMAO水平进行了测定,该研究也是他们首次调查急性心力衰竭患者机体中TMAO水平的变化;急性心力衰竭和高风险的死亡率及患者不健全表现直接相关,而研究者指出,肠道细菌和患者饮食也往往介导了TMAO水平的变化。

本文研究揭示了患者机体中TMAO循环水平和其急性心力衰竭预后的关联,研究者Suzuki说道,急性心力衰竭的患者往往饮食中代谢产物TMAO的水平较高,而且这些患者常常被要求入院进行治疗。研究者表示,高水平的TMAO和急性心力衰竭患者的较差预后直接相关,机体的特殊代谢途径或可帮助揭示患者摄入的红肉和心脏疾病发生之间的关联所在。(生物谷Bioon.com)

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Trimethylamine N-oxide and prognosis in acute heart failure

Toru Suzuki1, Liam M Heaney1, Sanjay S Bhandari1, Donald J L Jones1,2, Leong L Ng1

Objective Acute heart failure (AHF) is associated with high mortality and morbidity. Trimethylamine N-oxide (TMAO), a gut-derived metabolite, has reported association with mortality risk in chronic HF but this association in AHF is still unknown. The present study investigated TMAO in patients admitted to hospital with AHF, and association of circulating levels with prognosis. Methods In total, 972 plasma samples were analysed for TMAO concentration by liquid chromatography-mass spectrometry. Associations with in-hospital mortality (72 events), all-cause mortality (death, 268 events) and a composite of death or rehospitalisation due to HF (death/HF, 384 events) at 1 year were examined. Results TMAO improved risk stratification for in-hospital mortality in combination with current clinical scorings (OR≥1.13, p≤0.014). TMAO tertile analyses reported a graded risk in adverse outcome within 1 year (OR≥1.61, p≤0.004) and improved outcome prediction when stratified as none, one or both biomarker(s) elevated in combination with N-terminal pro B-type natriuretic peptide (NT-proBNP) (OR≥2.15, p≤0.007). TMAO was independently predictive for death and death/HF when corrected for cardiac risk factors (HR≥1.16, p≤0.037); however, this ability was weakened when indices of renal function were included, possibly due to multicollinearity. Conclusions TMAO contributed additional information on patient stratification for in-hospital mortality of AHF admissions using available clinical scores that include renal indices. Furthermore, elevated levels were associated with poor prognosis at 1 year and combination of TMAO and NT-proBNP provided additional prognostic information. TMAO was a univariate predictor of death and death/HF, and remained an independent predictor until adjusted for renal confounders.

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