Plasma Amino Acid Abnormalities in Chronic Heart Failure. Mechanisms, Potential Risks and Targets in Human Myocardium Metabolism.

Plasma Amino Acid Abnormalities in Chronic Heart Failure. Mechanisms, Potential Risks and Targets in Human Myocardium Metabolism.
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DOI:
10.3390/nu9111251
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发表时间:
2017-11-15
期刊:
影响因子:
5.9
通讯作者:
Boschi F
Boschi F
中科院分区:
医学2区
文献类型:
--
作者:
Aquilani R;La Rovere MT;Corbellini D;Pasini E;Verri M;Barbieri A;Condino AM;Boschi F

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本研究的目的是测量慢性心力衰竭(CHF)患者的动脉氨基酸水平,并将其与左心室功能和疾病严重程度联系起来。氨基酸(AAs)在心脏蛋白质-能量代谢中起着至关重要的作用。在心力衰竭中,很少测量作为心肌摄取AA的主要决定因素的动脉AA。分析了41例临床稳定CHF(纽约心脏协会(NYHA)II至IV级)受试者。禁食过夜后,从桡动脉采集血样以测量AA浓度。测量卡路里(Kcal I)、蛋白质、脂肪、碳水化合物摄入量、静息能量消耗(REE)、每日总能量消耗(REE × 1.3)和右心导管检查变量。八个匹配的对照进行了比较的所有测量,除了心导管插入术。与对照组相比,CHF患者动脉AA水平降低,其数量和降低率与心力衰竭(HF)严重程度相关。动脉天冬氨酸与每搏输出量指数(r = 0.6263; p < 0.0001)和心脏指数(r = 0.4243; p = 0.0028)相关。动脉天冬氨酸(µmol/L)乘以心脏指数与左心室射血分数相关(r = 0.3765; p = 0.0076)。所有NYHA心功能分级组的蛋白质摄入量均充足(≥1.1 g/kg/d),热量摄入不足(Kcal I < REE × 1.3)仅见于IV级患者。本研究表明CHF患者动脉AA水平降低与临床疾病严重程度和左心室功能不全直接相关。
The goal of this study was to measure arterial amino acid levels in patients with chronic heart failure (CHF), and relate them to left ventricular function and disease severity. Amino acids (AAs) play a crucial role for heart protein-energy metabolism. In heart failure, arterial AAs, which are the major determinant of AA uptake by the myocardium, are rarely measured. Forty-one subjects with clinically stable CHF (New York Heart Association (NYHA) class II to IV) were analyzed. After overnight fasting, blood samples from the radial artery were taken to measure AA concentrations. Calorie (KcalI), protein-, fat-, carbohydrate-intake, resting energy expenditure (REE), total daily energy expenditure (REE × 1.3), and cardiac right catheterization variables were all measured. Eight matched controls were compared for all measurements, with the exception of cardiac catheterization. Compared with controls, CHF patients had reduced arterial AA levels, of which both their number and reduced rates are related to Heart Failure (HF) severity. Arterial aspartic acid correlated with stroke volume index (r = 0.6263; p < 0.0001) and cardiac index (r = 0.4243; p = 0.0028). The value of arterial aspartic acid (µmol/L) multiplied by the cardiac index was associated with left ventricular ejection fraction (r = 0.3765; p = 0.0076). All NYHA groups had adequate protein intake (≥1.1 g/kg/day) and inadequate calorie intake (KcalI < REE × 1.3) was found only in class IV patients. This study showed that CHF patients had reduced arterial AA levels directly related to clinical disease severity and left ventricular dysfunction.
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