Metabolomic profiling of patients with high gradient aortic stenosis undergoing transcatheter aortic valve replacement.
Metabolomic profiling of patients with high gradient aortic stenosis undergoing transcatheter aortic valve replacement.
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DOI：
10.1007/s00392-020-01754-2
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Schulze PC
中科院分区：
文献类型：
--
作者：
Haase D;Bäz L;Bekfani T;Neugebauer S;Kiehntopf M;Möbius-Winkler S;Franz M;Schulze PC
本研究的目的是评估经导管主动脉瓣置换术（TAVR）前后主动脉瓣狭窄患者的代谢变化，并评估该手术是否能逆转代谢组学改变。采用液相色谱串联质谱法对30例重度高梯度主动脉瓣狭窄患者（tavr前和tavr后6周）和20例健康对照（HC）的188种血浆代谢物进行定量分析。在测量时，显著改变的代谢物与广泛的临床参数患者数据库相关。在测定的代谢物中，与HC相比，AS患者tavr前的代谢物有26.6% （n = 50）显著改变。其中，5/40酰基肉碱、10/42氨基酸和生物胺在as中主要增加，29/90甘油磷脂和6/15鞘磷脂主要减少。在tavr后组中，10.1% （n = 19）的代谢物与tavr前相比有显著差异。此外，我们发现9种代谢物显示可逆的浓度水平。与临床重要参数的相关性显示，神经磷脂与胆固醇（r = 0.847）、酰基肉碱与脑利钠肽（r = 0.664）有很强的相关性，酰基肉碱与左室射血分数（r = - 0.513）、磷脂酰胆碱与左室质量（r = - 0.637）有很强的相关性。代谢谱鉴定出AS患者循环代谢物显著且可逆的变化。循环代谢物与临床参数的相关性支持使用这些数据来识别疾病筛查、病理生理学研究以及患者监测的新诊断和预后标记。本文的在线版本（10.1007/s00392-020-01754-2）包含补充资料，仅供授权用户使用。
Aim of our study was to evaluate metabolic changes in patients with aortic stenosis (AS) before and after transcatheter aortic valve replacement (TAVR) and to assess whether this procedure reverses metabolomic alterations. 188 plasma metabolites of 30 patients with severe high-gradient aortic valve stenosis (pre-TAVR and 6 weeks post-TAVR) as well as 20 healthy controls (HC) were quantified by liquid chromatography tandem mass spectrometry. Significantly altered metabolites were then correlated to an extensive patient database of clinical parameters at the time of measurement. Out of the determined metabolites, 26.6% (n = 50) were significantly altered in patients with AS pre-TAVR compared to HC. In detail, 5/40 acylcarnitines as well as 10/42 amino acids and biogenic amines were mainly increased in AS, whereas 29/90 glycerophospholipids and 6/15 sphingomyelins were mainly reduced. In the post-TAVR group, 10.1% (n = 19) of metabolites showed significant differences when compared to pre-TAVR. Moreover, we found nine metabolites revealing reversible concentration levels. Correlation with clinically important parameters revealed strong correlations between sphingomyelins and cholesterol (r = 0.847), acylcarnitines and brain natriuretic peptide (r = 0.664) and showed correlation of acylcarnitine with an improvement of left ventricular (LV) ejection fraction (r = − 0.513) and phosphatidylcholines with an improvement of LV mass (r = − 0.637). Metabolic profiling identified significant and reversible changes in circulating metabolites of patients with AS. The correlation of circulating metabolites with clinical parameters supports the use of these data to identify novel diagnostic as well as prognostic markers for disease screening, pathophysiological studies as well as patient surveillance. The online version of this article (10.1007/s00392-020-01754-2) contains supplementary material, which is available to authorized users.
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