Study On The Relationship Between Plasma Levels Of Trimethylamine Oxide And Atrial Fibrillation In Patients With Coronary Heart Disease

Objectives The purpose of this study was to investigate plasma constituents of trimethylamine oxide,a cholinergic metabolite which was dependent on intestinal flora,in patients with coronary heart disease and those with coronary heart disease associated with atrial fibrillation,and to explore the relationship between plasma TMAO constituents and patients with coronary heart disease complicated with atrial fibrillation.Provide a certain reference for the prevention and treatment of atrial fibrillation in the future.Methods With coronary heart disease diagnosed by coronary angiography,a total of 200 patients who were admitted to the Department of Cardiology of the Fifth Affiliated Hospital of Zhengzhou University from October 2016 to June 2018,were selected as the study subjects.According to whether atrial fibrillation was associated with atrial fibrillation or not,140 patients with coronary heart disease and atrial fibrillation were selected as the experimental group and 60 patients with pure coronary heart disease as the control group.Peripheral blood samples were collected on the fasting day after admission,and 5 ml of peripheral blood was collected using EDTA biochemical anticoagulation tube.The content of TMAO in blood samples was determined by high performance liquid chromatography-tandem mass spectrometry.According to the patient's TMAO level quartile at the time of admission,the patients were divided into four groups(the first group: TMAO ? 2.7 ?mol / L;the second group: 2.7 ?mol / L <TMAO ? 5.0 ?mol / L;the third group: 5.0 ?mol / L)< TMAO ? 7.2 ?mol / L;Group4: TMAO > 7.2 ?mol / L);Clinical tests were performed using immunoassay:hypersensitive C-reactive protein,troponin I,N-terminal pro-brain natriuretic peptide precursor,homocysteine;detection of left ventricular ejection fraction,left ventricular end-diastolic by echocardiography Inner diameter,right ventricular internal diameter,left atrial anteroposterior diameter,right atrium left and right diameter;During the study,the general clinical data were recorded for age,gender,body mass index(BMI),smoking history and past disease history.The differences between the two groups were compared between clinical data,clinical test indicators and myocardial remodeling indexes.The difference in plasma TMAO levels in patients with coronary heart disease complicated with atrial fibrillation,and the correlation between changes in TMAO levels and these traditional clinical indicators,To explore the relationship between plasma TMAO level and the occurrence of atrial fibrillation in patients with coronary heart disease?Results1.There were significant differences in hs-CRP,LAD,RAD,NT-pro BNP,CTn I and TMAO between coronary heart disease group and coronary heart disease group(P<0.05).The other indexes were not statistically significant.2.Logistic regression analysis showed that LAD,RAD,NT-pro BNP and TMAO levels were independent predictors of atrial fibrillation(P<0.05),and the remaining variables could not independently predict the occurrence of atrial fibrillation(P>0.05).3.According to the quartile of all patients' TMAO levels,the clinical data were compared.The LAD,RAD and CTn I were higher in the fourth group than in the first group,NT-pro BNP and hs-CRP in the third and fourth groups.Higher than the first group,LVEF was lower in the third and fourth groups than in the first group,and the incidence of atrial fibrillation was higher with plasma TMAO levels(P < 0.001).4.Spearman rank correlation analysis between TMAO and atrial fibrillation predictors revealed that TMAO was positively correlated with LAD,hs-CRP,c Tn I and NT-pro BNP,and TMAO was negatively correlated with LVEF.Conclusions Plasma TMAO levels were associated with atrial fibrillation in patients with coronary heart disease,and with the increase in plasma TMAO levels,the prevalence of atrial fibrillation is on the rise,possibly by increasing inflammatory response,aggravating myocardial ischemia or increasing atrial fibrosis,promoting atrial remodeling,etc.It was easy for patients with coronary heart disease to induce atrial fibrillation.This time,through the study of intestinal metabolic pathways,it provided new ideas and therapeutic targets for the prevention and treatment of atrial fibrillation.