经导管主动脉瓣植入降低血浆TMAO和硫酸吲哚酚浓度:一项前瞻性、多中心队列研究。

Aleksandra Gąsecka, Marcelina Gniot, Bogna Rajewska, Weronika Dykacz, Weronika Kisielewska, Ewelina Błażejowska, Jakub M Zimodro, Marcin Grabowski, Bartosz Rymuza, Zenon Huczek, Janusz Kochman, Radosław Wilimski, Mariusz Kuśmierczyk, Jan Budzianowski, Jarosław Hiczkiewicz, Anna Olasińska-Wiśniewska, Marek Grygier, Krzysztof J Filipiak, Marcin Ufnal
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引用次数: 0

摘要

背景:肠道微生物代谢物,如三甲胺- n -氧化物(TMAO)和硫酸吲哚酚(IS),已被认为是主动脉瓣狭窄(as)进展的标志物。然而,经导管主动脉瓣植入术(TAVI)对这些肠道细菌代谢物的影响尚未在多中心临床研究中进行评估。本研究的目的是确定TAVI对肠道细菌代谢物血浆水平的影响,并评估这些代谢物对TAVI后主要不良心血管事件(MACE)的预测价值。方法:连续的AS患者被纳入TAVI研究。在TAVI前一天和出院时采集血样。采用超高效液相色谱联用质谱法测定肠道微生物代谢物浓度。结果:与基线相比,TAVI后血浆TMAO和IS水平下降(p≤0.004)。在纳入研究的128例患者中,21例(16.4%)患者在中位随访404天期间发生MACE。与没有MACE的患者相比,MACE患者的基线血浆IS水平更高(p = 0.001)。增加的基线IS水平预测MACE的敏感性为75.0%,特异性为74.3%,独立于其他临床变量(OR 14.264, 95% CI 3.442-59.117, p < 0.001),并降低无事件生存的机会(plog rank < 0.001)。结论:与基线相比,TAVI后血浆TMAO和IS浓度降低。在中位随访404天期间,血浆IS水平升高与tavi后MACE发生率增加14倍相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transcatheter aortic valve implantation reduces plasma concentrations of TMAO and indoxyl sulfate: A prospective, multicenter cohort study.

Background: Intestinal microbial metabolites, such as trimethylamine-N-oxide (TMAO) and indoxyl sulfate (IS), have been suggested as markers for the progression of aortic stenosis (AS). However, the impact of transcatheter aortic valve implantation (TAVI) on these intestinal bacterial metabolites has not been evaluated in a multicenter clinical study. The aim of this study was to determine the effect of TAVI on plasma levels of intestinal bacterial metabolites and to assess the predictive value of these metabolites for major adverse cardiovascular events (MACE) following TAVI. M: ETHODS: Consecutive patients with AS referred for TAVI were enrolled in this study. Blood samples were collected one day before TAVI and at hospital discharge. The concentrations of intestinal microbial metabolites were measured using ultra performance liquid chromatograph coupled with a mass spectrometer.

Results: Plasma levels of TMAO and IS decreased after TAVI, compared to baseline (p ≤ 0.004 for all). Among 128 patients included in the study, 21 patients (16.4%) developed MACE during the median follow-up time of 404 days. Baseline plasma IS level was higher in patients with MACE, compared to those without MACE (p = 0.001). Increased baseline IS level predicted MACE with 75.0% sensitivity and 74.3% specificity independent of other clinical variables (OR 14.264, 95% CI 3.442-59.117, p < 0.001) and decreased the chance of event-free survival (plog rank < 0.001).

Conclusions: Plasma concentrations of TMAO and IS decreased after TAVI, compared to baseline. Elevated plasma IS levels were associated with a 14-fold increase in the odds of post-TAVI MACE during a median follow-up period of 404 days.

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