Usefulness of the plasma branched-chain amino acid/Aromatic amino acid ratio for predicting future cardiac events in patients with heart failure
Usefulness of the plasma branched-chain amino acid/Aromatic amino acid ratio for predicting future cardiac events in patients with heart failure
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DOI：
10.1016/j.jjcc.2019.12.016
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发表时间：
2020-06-01
影响因子：
2.5
通讯作者：
Murohara, Toyoaki
中科院分区：
文献类型：
--
作者：
Hiraiwa, Hiroaki;Okumura, Takahiro;Murohara, Toyoaki
背景资料：心力衰竭（HF）是一种高分解代谢状态，其促进心脏和骨骼肌中支链氨基酸（BCAA）的分解代谢活性，并减少肝脏中的蛋白质合成。因此，血浆游离芳香族氨基酸（AAAs）增加。我们研究了BCAA/AAA比值（Fischer's ratio，FR）在HF患者中的预后价值。方法：我们纳入了157例因HF恶化而住院的连续患者（81例男性，76例女性;平均± SD年龄75 ± 14岁）。在患者病情稳定时（出院时）测量血浆BCAA水平（即总亮氨酸、异亮氨酸、缬氨酸）和AAA水平（即总酪氨酸、苯丙氨酸）。FR计算为合并的血浆BCAA水平除以AAA水平。心脏事件定义为心源性死亡和因HF恶化而住院的复合事件。结果：根据中位FR将患者分为两组（高FR组：FR> 3.1，n = 78;低FR组：FR> 3.1，n = 78）。
Background: Heart failure (HF) is a hypercatabolic state that promotes branched-chain amino acid (BCAA) catabolic activity in the heart and skeletal muscle and reduces protein synthesis in the liver. Consequently, plasma free aromatic amino acids (AAAs) are increased. We investigated the prognostic value of the BCAA/AAA ratio (Fischer's ratio, FR) in patients with HF.Methods: We enrolled 157 consecutive patients hospitalized for worsening HF (81 men, 76 women; mean +/- SD age 75 +/- 14 years). Plasma BCAA levels (i.e. total leucine, isoleucine, valine) and AAA levels (i.e. total tyrosine, phenylalanine) were measured at a time when the patients were stabilized (at discharge). FR was calculated as the combined plasma BCAA levels divided by the AAA level. Cardiac events were defined as a composite of cardiac death and hospitalization for worsening HF.Results: The patients were divided into two groups based on the median FR (high-FR group: FR > 3.1, n= 78; low-FR group: FR