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Trimethylamine N-Oxide Levels Are Associated with Severe Aortic Stenosis and Predict Long-Term Adverse Outcome

Yuchao Guo1, Shaojun Xu1, Hong Zhan2

  • 1Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.

Journal of Clinical Medicine
|January 21, 2023
PubMed

Insights

Elevated trimethylamine N-oxide (TMAO) levels are linked to aortic stenosis and predict higher mortality risk in patients undergoing transcatheter aortic valve replacement (TAVR). Higher TMAO indicates a poorer prognosis post-TAVR.

Area of Science:

  • Cardiovascular Medicine
  • Microbial Metabolomics
  • Clinical Prognostics

Background:

  • Trimethylamine N-oxide (TMAO) is a microbial metabolite associated with cardiovascular diseases.
  • The relationship between TMAO and aortic stenosis, as well as its prognostic value post-transcatheter aortic valve replacement (TAVR), requires further investigation.

Purpose of the Study:

  • To investigate the association between TMAO levels and aortic stenosis.
  • To determine the prognostic significance of TMAO for predicting mortality after TAVR.

Main Methods:

  • A retrospective study included 299 patients with severe aortic stenosis and 711 controls.
  • Propensity score matching created 126 pairs for analysis.
  • Survival analyses stratified by TMAO quartiles assessed the primary outcome of all-cause mortality.

Main Results:

  • Severe aortic stenosis patients exhibited significantly higher TMAO levels compared to controls (p < 0.001).
  • Elevated TMAO was associated with increased 2-year all-cause mortality (19.2% vs. 9.5%, p = 0.028) and late cumulative mortality (34.2% vs. 19.1%, p = 0.004).
  • Higher TMAO remained an independent predictor of mortality post-TAVR (HR 1.788, p = 0.028) after multivariate adjustment.

Conclusions:

  • TMAO levels are elevated in patients with aortic stenosis.
  • Elevated TMAO is a significant predictor of adverse outcomes and mortality following TAVR.
Keywords:
aortic stenosisgut microbiotaprognosistrimethylamine N-oxide

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