Prognostic value of elevated levels of intestinal microbe-generated metabolite trimethylamine-N-oxide in patients with heart failure: refining the gut hypothesis.
Prognostic value of elevated levels of intestinal microbe-generated metabolite trimethylamine-N-oxide in patients with heart failure: refining the gut hypothesis.
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DOI：
10.1016/j.jacc.2014.02.617
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发表时间：
2014-11-04
影响因子：
24
通讯作者：
Hazen, Stanley L.
中科院分区：
文献类型：
--
作者：
Tang, W. H. Wilson;Wang, Zeneng;Fan, Yiying;Levison, Bruce;Hazen, Jennie E.;Donahue, Lillian M.;Wu, Yuping;Hazen, Stanley L.
肠功能改变在心力衰竭（HF）患者中很普遍，但其在不良结局中的作用尚不清楚。本研究探讨了肠道微生物群在心衰中的潜在病理生理作用。我们研究了720例稳定型心衰患者5年随访期间空腹血浆三甲胺- n -氧化物（TMAO）与全因死亡率之间的关系。TMAO水平中位数为5.0 μM，高于非hf组（3.5 μM; p < 0.001）。TMAO与b型利钠肽（BNP）有轻微但显著的相关性（r = 0.23; p < 0.001）。较高的血浆TMAO水平与死亡风险增加3.4倍相关。在对传统危险因素和BNP进行调整后，TMAO水平升高仍然可以预测5年死亡风险（风险比[HR]: 2.2； 95%可信区间[CI]: 1.42至3.43;p < 0.001），以及在模型中加入肾小球滤过率（HR: 1.75; 95% CI: 1.07至2.86;p < 0.001）。在心衰患者中观察到高TMAO水平，TMAO水平升高预示着与传统危险因素无关的更高的长期死亡风险。
Altered intestinal function is prevalent in patients with heart failure (HF), but its role in adverse outcomes is unclear. This study investigated the potential pathophysiologic contributions of intestinal microbiota in HF. We examined the relationship between fasting plasma trimethylamine-N-oxide (TMAO) and all-cause mortality over 5-year follow-up in 720 stable subjects with HF. Median TMAO level was 5.0 μM, which was higher than in non-HF subjects (3.5 -μM; p < 0.001). There was modest but significant correlation between TMAO and B-type natriuretic peptide (BNP) (r = 0.23; p < 0.001). Higher plasma TMAO level was associated with a 3.4-fold increased mortality risk. Following adjustments for traditional risk factors and BNP, elevated TMAO levels remained predictive of 5-year mortality risk (hazard ratio [HR]: 2.2; 95% confidence interval [CI]: 1.42 to 3.43; p < 0.001), as well as following the addition of estimated glomerular filtration rate to the model (HR: 1.75; 95% CI: 1.07 to 2.86; p < 0.001). High TMAO levels are observed in patients with HF and elevated TMAO levels portend higher long-term mortality risk independent of traditional risk factors.
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DOI：
10.1056/nejmoa1109400
发表时间：
2013-04-25
期刊：
The New England journal of medicine
影响因子：
--
作者：
Tang WH;Wang Z;Levison BS;Koeth RA;Britt EB;Fu X;Wu Y;Hazen SL
通讯作者：
Hazen SL
磷脂酰胆碱的肠道菌群代谢促进心血管疾病。
影响因子：
64.8
作者：
Wang, Zeneng;Klipfell, Elizabeth;Bennett, Brian J.;Koeth, Robert;Levison, Bruce S.;Dugar, Brandon;Feldstein, Ariel E.;Britt, Earl B.;Fu, Xiaoming;Chung, Yoon-Mi;Wu, Yuping;Schauer, Phil;Smith, Jonathan D.;Allayee, Hooman;Tang, W. H. Wilson;DiDonato, Joseph A.;Lusis, Aldons J.;Hazen, Stanley L.
通讯作者：
Hazen, Stanley L.
影响因子：
19.7
作者：
HANLEY, JA;MCNEIL, BJ
通讯作者：
MCNEIL, BJ
影响因子：
82.9
作者：
Koeth RA;Wang Z;Levison BS;Buffa JA;Org E;Sheehy BT;Britt EB;Fu X;Wu Y;Li L;Smith JD;DiDonato JA;Chen J;Li H;Wu GD;Lewis JD;Warrier M;Brown JM;Krauss RM;Tang WH;Bushman FD;Lusis AJ;Hazen SL
通讯作者：
Hazen SL
影响因子：
24
作者：
Mullens, Wilfried;Abrahams, Zuhelr;Tang, W. H. Wilson
通讯作者：
Tang, W. H. Wilson