The Correlation Analysis Among Coronary Heart Disease,Intestinal Flora And Its Metabolite Of Trimethylamine-N-oxide

Objectives:It has been found that the level of trimethylamine-N-oxide(TMAO)is closely related to the pathogenesis of coronary heart disease,and the regulation of intestinal flora and its metabolites may be a new target for the treatment of cardiovascular diseases.The purpose of this study was to investigate the changes of intestinal flora in patients with acute coronary syndrome(ACS),chronic coronary artery disease(CAD)and healthy people,to analyze the difference of plasma TMAO levels in each group,and to screen the flora closely related to TMAO.Methods: From October 2018 to December 2018,a total of 60 subjects were enrolled in the study.All of them were underwent coronary angiography during hospitalization.Fecal and plasma samples were collected from patients with ACS group(n = 21),CAD group(n = 20)and healthy Control group(Control group,n =19).The intestinal microflora of the patients was studied by 16 s r DNA sequencing.The level of the plasma TMAO was measured by enzyme-linked immunosorbent assay(ELISA)and compared among the three groups.The correlation between TMAO and intestinal flora was analyzed.Results: 1.The sequencing results of facal showed that there were significant differences among the three groups(P < 0.05)in microflora Verrucomicrobia and Epsilonbacteraeota at the phylum level(P < 0.05).At the genus level,Akkermansia,Campylobacter,Fretibacterium,Sphingomonas,Selenomonas,Weissella and Paraclostridium had significant differences among the three groups(P<0.05).2.The results of diversity analysis showed that the components of microflora of ACS group was similar to that of CAD group,and there was difference between ACS group and Control group.LDA Effect Size analysis showed that the main specific flora of ACS group was Sphingomonas,and the main specific flora of CAD group was Paraclostridium.3.The concentration of TMAO in plasma of ACS group and CAD group was significantly higher than that in Control group(P< 0.05).4.The correlation analysis between the concentration of TMAO in plasma and intestinal flora showed that the level of TMAO in ACS patients was correlated with Acidaminococcus,Ruminococcus,Victivallis,Anaerotruncus,Intestinimonas,Hydrogenoanaero,Family_XIII_AD3011,Gca900066755,and the level of TMAO in CAD patients was correlated with Actinomyces,Granulicatella,Selenomonas.Conclusion: There were significant differences in the specific intestinal flora,components of microflora,the concentration of TMAO in plasma and related microflora among ACS group,CAD group and Control group.In the future,it may provide a new theoretical basis for the pathogenesis and diagnosis of coronary heart disease through the detection of intestinal flora and its metabolite TMAO.