Analysis of the relationship between plasma carnitine levels and non-valvular atrial fibrillation

Abstract

Objective To investigate the correlation between plasma carnitine levels and atrial fibrillation and its predictive value in atrial fibrillation by analyzing the changes of plasma carnitine levels in patients with atrial fibrillation (AF) by metabolomics methods. Methods The clinical data of consecutive patients with non-valvular atrial fibrillation admitted to the Second Hospital of Dalian Medical University from January 2020 to January 2022 and patients with sinus rhythm admitted for other reasons during the same period were collected, and the relationship between plasma carnitine levels and atrial fibrillation was investigated by analyzing the general clinical characteristics (including age, sex, blood pressure, blood lipids, body mass index, history of smoking, history of alcohol consumption, blood uric acid, left atrial internal diameter, history of hypertension, history of cerebral infarction, history of coronary artery disease) and laboratory test results such as plasma carnitine levels in both groups. Results In our study, a total of 195 patients were included in this study, including 90 patients in the atrial fibrillation group (including 45 patients with paroxysmal atrial fibrillation and 45 patients with persistent atrial fibrillation) and 105 patients in the sinus rhythm group. The plasma free carnitine CO, acetyl carnitine C2, propionyl carnitine C3, butyryl carnitine C4, isovaleryl carnitine C5, hydroxyisovaleryl carnitine C5-OH, palmitoyl carnitine C16, octadecanoyl carnitine C18, and 26-carbonyl carnitine C26 were significantly higher in the atrial fibrillation group than in the sinus rhythm group, and the differences were statistically significant (P < 0.05). The plasma acetylcarnitine C2, hydroxybutyrylcarnitine C4-OH, palmitoylcarnitine C16, and hydroxypalmitoylcarnitine C16:1-OH levels were significantly higher in the persistent AF group than in the paroxysmal AF group, and the differences were statistically significant (P < 0.05). Binary logistic regression analysis revealed that age, high-density lipoprotein, left atrial internal diameter, and free carnitine CO were independent risk factors for the development of atrial fibrillation. Conclusion Patients with atrial fibrillation have altered plasma levels of some carnitine, and the occurrence of atrial fibrillation may be related to disturbances in the metabolism of this part of carnitine. Free carnitine CO is an independent correlate of atrial fibrillation, and its elevated levels suggest that patients may be prone to atrial fibrillation.

Expression of PDGFR-<i>α</i> in Patients with Valvular Atrial Fibrillation

“…The studies indicated that the atrial diameters in the atrial fibrillation group were apparently greater than those in the SR group; Atrial tissue in the atrial fibrillation group has visible fibrosis changes; the relative expression of type I collagen mRNA (2 −ΔΔCt ) in the atrial muscle samples from patients with atrial fibrillation was markedly higher than that in patients with sinus rhythm. It is suggested that the occurrence and development of atrial fibrosis in patients with rheumatic valvular disease and atrial fibrillation may be related to the up-regulation of the transcription level of type I collagen gene, the increase of synthesis and secretion of type I collagen, which leads to the abnormal accumulation of collagen in atrial tissue and the imbalance of I/III collagen deposition ratio, which provides a pathological matrix for the occurrence and maintenance of atrial fibrillation [12] [13] [14]. Whether PDGF/PDGFR signal is involved in the occurrence, development and maintenance of atrial fibrosis due to valvular atrial fibrillation by up-regulating the transcription level of type I collagen gene, it leads to the increase of fibroblast synthesis and secretion of type I collagen, and abnormal accumulation of collagen in atrial tissue remains to be further studied.…”