Pre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablation

Abstract Background Numerous studies have demonstrated the significance of trimethylamine-N-oxide (TMAO) in the progression of atrial fibrillation (AF). However, the association between TMAO and AF recurrence (RAF) post-catheter ablation is not yet fully understood. This study aims to elucidate the...

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Main Authors: Siyu Meng, Tianyi Ni, Qiuyao Du, Mengjie Liu, Peibing Ge, Jin Geng, Bingjian Wang
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-024-04170-w
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author Siyu Meng
Tianyi Ni
Qiuyao Du
Mengjie Liu
Peibing Ge
Jin Geng
Bingjian Wang
author_facet Siyu Meng
Tianyi Ni
Qiuyao Du
Mengjie Liu
Peibing Ge
Jin Geng
Bingjian Wang
author_sort Siyu Meng
collection DOAJ
description Abstract Background Numerous studies have demonstrated the significance of trimethylamine-N-oxide (TMAO) in the progression of atrial fibrillation (AF). However, the association between TMAO and AF recurrence (RAF) post-catheter ablation is not yet fully understood. This study aims to elucidate the predictive capability of pre-procedural TMAO levels in determining RAF following catheter ablation (CA). Methods This study was conducted as a prospective, single-center observational study. Between June 2021 and June 2022, 152 patients from the Department of Cardiology at The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University were enrolled. Baseline characteristics and serum TMAO levels were assessed for all participants. Patients with AF who underwent CA were monitored for recurrences of AF using electrocardiography (ECG) or 24-hour Holter monitoring during the follow-up period. Results The study found that serum TMAO levels were significantly higher in persistent AF (PeAF) patients compared to those in sinus rhythm (SR) and paroxysmal AF (PaAF) patients (3.96 ± 1.69 vs. 1.81 ± 0.59, 3.02 ± 1.50 µM, P < 0.001 and P < 0.01, respectively). After a one-year follow-up, 29 (21.2%) AF patients experienced recurrence after CA. Multivariate Cox proportional hazards regression analysis revealed that pre-procedural serum TMAO was an independent predictor of recurrent AF (HR = 1.78, 95% CI = 1.43–2.21, P < 0.001). The receiver operating characteristic (ROC) curve analysis identified a cut-off value of 4.3µM for serum TMAO levels in predicting recurrent AF (area under the curve: 0.835, P < 0.001). The Kaplan-Meier plot demonstrated that patients with TMAO levels greater than 4.3µM had a significantly higher rate of recurrent AF (HR = 13.53, 95% CI = 6.19–29.56, P < 0.001). Conclusion Patients with AF exhibited elevated levels of circulating TMAO compared to patients with SR. The findings suggest a potential role of TMAO in the development of AF, with pre-procedural serum TMAO levels serving as a reliable predictor of recurrence of AF CA.
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spelling doaj-art-5e47f5ab96524481ad4a7ac853238b5b2024-12-29T12:09:40ZengBMCBMC Cardiovascular Disorders1471-22612024-12-0124111010.1186/s12872-024-04170-wPre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablationSiyu Meng0Tianyi Ni1Qiuyao Du2Mengjie Liu3Peibing Ge4Jin Geng5Bingjian Wang6Department of Cardiology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical UniversityDepartment of Cardiology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical UniversityDepartment of Cardiology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical UniversityDepartment of Cardiology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical UniversityDepartment of Cardiology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical UniversityDepartment of Cardiology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical UniversityDepartment of Cardiology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical UniversityAbstract Background Numerous studies have demonstrated the significance of trimethylamine-N-oxide (TMAO) in the progression of atrial fibrillation (AF). However, the association between TMAO and AF recurrence (RAF) post-catheter ablation is not yet fully understood. This study aims to elucidate the predictive capability of pre-procedural TMAO levels in determining RAF following catheter ablation (CA). Methods This study was conducted as a prospective, single-center observational study. Between June 2021 and June 2022, 152 patients from the Department of Cardiology at The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University were enrolled. Baseline characteristics and serum TMAO levels were assessed for all participants. Patients with AF who underwent CA were monitored for recurrences of AF using electrocardiography (ECG) or 24-hour Holter monitoring during the follow-up period. Results The study found that serum TMAO levels were significantly higher in persistent AF (PeAF) patients compared to those in sinus rhythm (SR) and paroxysmal AF (PaAF) patients (3.96 ± 1.69 vs. 1.81 ± 0.59, 3.02 ± 1.50 µM, P < 0.001 and P < 0.01, respectively). After a one-year follow-up, 29 (21.2%) AF patients experienced recurrence after CA. Multivariate Cox proportional hazards regression analysis revealed that pre-procedural serum TMAO was an independent predictor of recurrent AF (HR = 1.78, 95% CI = 1.43–2.21, P < 0.001). The receiver operating characteristic (ROC) curve analysis identified a cut-off value of 4.3µM for serum TMAO levels in predicting recurrent AF (area under the curve: 0.835, P < 0.001). The Kaplan-Meier plot demonstrated that patients with TMAO levels greater than 4.3µM had a significantly higher rate of recurrent AF (HR = 13.53, 95% CI = 6.19–29.56, P < 0.001). Conclusion Patients with AF exhibited elevated levels of circulating TMAO compared to patients with SR. The findings suggest a potential role of TMAO in the development of AF, with pre-procedural serum TMAO levels serving as a reliable predictor of recurrence of AF CA.https://doi.org/10.1186/s12872-024-04170-wAtrial fibrillation recurrenceTMAOCatheter ablationPredictor
spellingShingle Siyu Meng
Tianyi Ni
Qiuyao Du
Mengjie Liu
Peibing Ge
Jin Geng
Bingjian Wang
Pre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablation
BMC Cardiovascular Disorders
Atrial fibrillation recurrence
TMAO
Catheter ablation
Predictor
title Pre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablation
title_full Pre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablation
title_fullStr Pre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablation
title_full_unstemmed Pre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablation
title_short Pre-procedural TMAO as a predictor for recurrence of atrial fibrillation after catheter ablation
title_sort pre procedural tmao as a predictor for recurrence of atrial fibrillation after catheter ablation
topic Atrial fibrillation recurrence
TMAO
Catheter ablation
Predictor
url https://doi.org/10.1186/s12872-024-04170-w
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