三甲基胺N-氧化物作为左心室静脉功能障碍和STEMI后功能重塑的生物标志物
Tsung-Ying Tsai1,2, Ali Aldujeli3, Ayman Haq4
1CORRIB Research Centre for Advanced Imaging and Core Lab, University of Galway, H91 TK33 Galway, Ireland.
International journal of molecular sciences
|April 17, 2025
概括
在ST升高心肌梗塞 (STEMI) 三个月后测量的三甲基胺N氧化物 (TMAO) 可以预测不良的左心室重塑和腹功能障碍. 这种肠道生物标志物有助于识别高风险患者进行早期心力衰竭干预.
科学领域:
- 心脏病学 心脏病学
- 肠道微生物组研究研究
- 生物标志物发现发现
背景情况:
- 尽管初级皮肤冠状动脉干预 (PPCI) 成功,但心力衰竭 (HF) 发病率仍然很高ST升高后心肌梗塞 (STEMI).
- 不良的功能性左心室重塑 (FLVR) 和扩张功能障碍 (DD) 是STEMI后HF的关键前体.
- 肠道微生物群衍生代谢物的作用,如三甲基胺N氧化物 (TMAO),在预测这些不良结果方面需要进一步调查.
研究的目的:
- 在PPCI后的STEMI患者中,研究三甲基胺N氧化物 (TMAO) 作为不利的功能左心室重塑 (FLVR) 和/或扩张功能障碍 (DD) 的预测生物标志物.
- 评估基线和3个月TMAO水平与HF前体发展的关联.
- 评估TMAO对传统风险因素的附加预测价值,以评估不良LV重塑和DD的传统风险因素.
主要方法:
- 在PPCI后对204名多血管冠状动脉疾病的STEMI患者进行了前性观察性研究.
- 在基线和STEMI后3个月测量TMAO水平.
- 在基线和12个月时进行心声扫描,以评估左心室功能,重塑和扩张功能障碍.
主要成果:
- 在STEMI发作后三个月,TMAO水平有效地歧视了4级FLVR (AUC=0.77) 和≥II级DD (AUC=0.72) 的患者.
- 将3个月的TMAO水平添加到传统的风险因素中,显著改善了FLVR 4级 (AUC从0.793增加到0.873) 和≥II级DD (AUC从0.675增加到0.736) 的预测模型.
- 多变量分析证实3个月TMAO作为≥II级DD (OR:1.29) 和FLVR等级4 (OR:1.28) 的独立预测因子.
结论:
- 三个月的TMAO水平与左心室透静功能障碍和STEMI后不良重塑密切相关.
- TMAO显示出作为一种有价值的生物标志物的潜力,用于早期识别患有心力衰竭高风险的STEMI患者.
- 使用TMAO的早期鉴定可能有助于及时进行治疗干预,以减轻不良的心脏重塑和预防HF进展.
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