Correlation Of Serum High-sensitivity C-reactive Protein,trimethylamine N-oxide And Coronary Flow Reserve In Patients With Coronary Artery Disease

Objective:It has been found that some metabolites produced by human intestinal flora play a significant role in the pathogenesis of coronary atherosclerosis,which may be related to the dysregulation of intestinal flora promoting the production of inflammatory mediators.In this study,we investigated the correlation between high-sensitivity C-reactive protein(hsCRP),trimethylamine N-oxide(TMAO)and coronary flow reserve(CFR)in patients with coronary heart disease.Methods:Ten outpatients diagnosed with obstructive coronary artery disease by coronary angiography at the First Hospital of Shanxi Medical University were selected,five of whom had a combination of gastrointestinal inflammatory disease(diagnosis of gastroduodenitis and gastroduodenal ulcer by gastroscopy),Myocardial perfusion imaging(MPI)was performed on a single day for both rest and stress myocardium,using positron emission tomography(PET).The images were analysed using Heartsee software and the specific myocardial blood flow(MBF)and CFR were calculated for each subject.The haemodynamic and cardiac function parameters were recorded for each subject and the corrected CFR values were calculated,while venous blood was drawn for the determination of serum ultra-sensitive C-reactive protein and TMAO and its analogues prior to rest and stress PETMPI,Serum hsCRP was measured by enzyme-linked immunosorbent assay,and TMAO and its analogs were measured by stable isotope liquid chromatography/mass spectrometry.Results:1.A total of 10 subjects,all of whom were male,were included in this study.No significant difference in general clinical information between the group with coronary artery disease combined with inflammatory diseases of the gastrointestinal tract and the group without(P>0.05).2.The differences in resting heart rate and heart rate systolic product between the two groups were statistically significant(51.80±2.59 vs.81.40±2.30,P<0.05;6265.40±471.48 vs.10656.40±1667.27,P<0.05),statistically significant differences in heart rate under stress(80.40±14.26 vs.95.80±3.90,P<0.05),and no statistically significant differences in the remaining hemodynamic parameters between the two groups(P>0.05).3.The differences in cardiac functional parameters and myocardial blood flow between the two groups at rest and at stress were not statistically significant(P>0.05),and the corrected CFR values in the group with coronary artery disease combined with GI inflammatory disease were smaller than those in the group with coronary artery disease without GI inflammatory disease(2.45±0.41 vs.3.37±0.78,P< 0.05).4.Serum hsCRP in patients with coronary artery disease was negatively correlated with corrected CFR values(r=-0.739,P<0.05)and a correlation between serum TMAO and its analogues and corrected CFR values cannot yet be considered(P>0.05).Conclusion:(1).Inflammatory diseases of the digestive tract can lead to reduced coronary blood flow reserve in patients with coronary artery disease..(2).Serum hsCRP in patients with coronary artery disease is negatively correlated with coronary flow reserve.(3).The present study cannot yet conclude that there is a correlation between serum TMAO and coronary flow reserve in patients with coronary artery disease.