The Impact of Trimethylamine N-Oxide and Coronary Microcirculatory Dysfunction on Outcomes following ST-Elevation Myocardial Infarction

Aldujeli, Ali; Patel, Riddhi; Grabauskyte, Ingrida; Hamadeh, Anas; Lieponyte, Austeja; Tatarūnas, Vacis; Khalifeh, Hussein; Briedis, Kasparas; Skipskis, Vilius; Aldujeili, Montazar; Jarašūnienė, Dalia; Rana, Sumit; Unikas, Ramūnas; Haq, Ayman

doi:10.3390/jcdd10050197

Cited by 7 publications

(2 citation statements)

References 36 publications

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“…Conversely, elevated plasma levels of TMAO independently correlated with a high risk of plaque rupture in STEMI patients ( 245 ). Additionally, studies have consistently indicated that high TMAO levels are positively associated with MACEs, atrial fibrillation, and coronary atherosclerotic burden ( 209 , 213 , 246 – 248 ). TMAO holds promise as a valuable biomarker for predicting poor prognosis and improving risk assessment and management in MI patients.…”

Section: Single-omics Approachesmentioning

confidence: 99%

From multi-omics approaches to personalized medicine in myocardial infarction

Zhan,

Tang,

et al. 2023

Front. Cardiovasc. Med.

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Myocardial infarction (MI) is a prevalent cardiovascular disease characterized by myocardial necrosis resulting from coronary artery ischemia and hypoxia, which can lead to severe complications such as arrhythmia, cardiac rupture, heart failure, and sudden death. Despite being a research hotspot, the etiological mechanism of MI remains unclear. The emergence and widespread use of omics technologies, including genomics, transcriptomics, proteomics, metabolomics, and other omics, have provided new opportunities for exploring the molecular mechanism of MI and identifying a large number of disease biomarkers. However, a single-omics approach has limitations in understanding the complex biological pathways of diseases. The multi-omics approach can reveal the interaction network among molecules at various levels and overcome the limitations of the single-omics approaches. This review focuses on the omics studies of MI, including genomics, epigenomics, transcriptomics, proteomics, metabolomics, and other omics. The exploration extended into the domain of multi-omics integrative analysis, accompanied by a compilation of diverse online resources, databases, and tools conducive to these investigations. Additionally, we discussed the role and prospects of multi-omics approaches in personalized medicine, highlighting the potential for improving diagnosis, treatment, and prognosis of MI.

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Section: Single-omics Approachesmentioning

confidence: 99%

From multi-omics approaches to personalized medicine in myocardial infarction

Zhan,

Tang,

et al. 2023

Front. Cardiovasc. Med.

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“…The link between abnormal CFR, IMR, and unfavorable clinical outcomes in patients with STEMI has been repeatedly demonstrated. 8 , 9 …”

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confidence: 99%

Impact of Coronary Microvascular Dysfunction on Functional Left Ventricular Remodeling and Diastolic Dysfunction

Aldujeli,

Tsai,

Haq

et al. 2024

JAHA

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Background Coronary microvascular dysfunction (CMD) is a common complication of ST‐segment–elevation myocardial infarction (STEMI) and can lead to adverse cardiovascular events. Whether CMD after STEMI is associated with functional left ventricular remodeling (FLVR) and diastolic dysfunction, has not been investigated. Methods and Results This is a nonrandomized, observational, prospective study of patients with STEMI with multivessel disease. Coronary flow reserve and index of microcirculatory resistance of the culprit vessel were measured at 3 months post‐STEMI. CMD was defined as index of microcirculatory resistance ≥25 or coronary flow reserve <2.0 with a normal fractional flow reserve. We examined the association between CMD, LV diastolic dysfunction, FLVR, and major adverse cardiac events at 12‐month follow‐up. A total of 210 patients were enrolled; 59.5% were men, with a median age of 65 (interquartile range, 58–76) years. At 3‐month follow‐up, 57 patients (27.14%) exhibited CMD. After 12 months, when compared with patients without CMD, patients with CMD had poorer LV systolic function recovery (−10.00% versus 8.00%; P <0.001), higher prevalence of grade 2 LV diastolic dysfunction (73.08% versus 1.32%; P <0.001), higher prevalence of group 3 or 4 FLVR (11.32% versus 7.28% and 22.64% versus 1.99%, respectively; P <0.001), and higher incidence of major adverse cardiac events (50.9% versus 9.8%; P <0.001). Index of microcirculatory resistance was independently associated with LV diastolic dysfunction and adverse FLVR. Conclusions CMD is present in ≈1 of 4 patients with STEMI during follow‐up. Patients with CMD have a higher prevalence of LV diastolic dysfunction, adverse FLVR, and major adverse cardiac events at 12 months compared with those without CMD. Registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT05406297.

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Correlation between coronary microvascular dysfunction and cardiorespiratory fitness in patients with ST-segment elevation myocardial infarction

Li,

Zhao,

Tian

et al. 2024

Sci Rep

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We retrospectively investigated the relationship between cardiopulmonary exercise testing (CPET) parameters and coronary microvascular dysfunction (CMD) using a novel angiography-based index of microcirculatory resistance (AccuIMR) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) with complete revascularization. In 418 patients, the culprit vessel AccuIMR was calculated after successful primary PCI. CPET was conducted 44.04 ± 19.28 days after primary PCI. Overall, 157 patients (37.6%) showed elevated AccuIMR (> 40 U) in the culprit vessels. The LVEF was significantly lower in the CMD group than in the Non-CMD group. The CMD group showed worse results in VO2peak, peak O2-pulse, and VE/VCO2 slope than the Non-CMD group. Spearman correlation analysis suggested that VO2peak ( r = -0.354), peak O2-pulse ( r = -0.385) and VE/VCO2 slope ( r = 0.294) had significant linear correlations with AccuIMR ( P < 0.001). Multivariable logistic regression analysis showed that AccuIMR was the independent predictor of reduced VO2peak and elevated VE/VCO2 slope. The proportions of positive and equivocal ECG results and early O2-pulse flattening in the CMD group were significantly higher than those in the Non-CMD group, and AccuIMR was the only independent predictor of these ischemia-relating indicators, suggesting that patients with CMD had significant noninvasively detectable myocardial ischemia. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-74948-7.

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The Impact of Trimethylamine N-Oxide and Coronary Microcirculatory Dysfunction on Outcomes following ST-Elevation Myocardial Infarction

Cited by 7 publications

References 36 publications

From multi-omics approaches to personalized medicine in myocardial infarction

From multi-omics approaches to personalized medicine in myocardial infarction

Impact of Coronary Microvascular Dysfunction on Functional Left Ventricular Remodeling and Diastolic Dysfunction

Correlation between coronary microvascular dysfunction and cardiorespiratory fitness in patients with ST-segment elevation myocardial infarction

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