Elevated TMAO levels (3.64 µM) were significantly associated with HFrEF and correlated with cardiac function parameters and severity (AUC = 0.853).
Is elevated serum TMAO associated with heart failure with reduced ejection fraction (HFrEF) and can it serve as a diagnostic biomarker?
Elevated serum TMAO levels are independently associated with HFrEF severity and demonstrate strong discriminative ability, suggesting its potential utility as a biomarker for risk stratification.
Absolute Event Rate: 0% vs 0%
Gut-derived metabolites, particularly trimethylamine N-oxide (TMAO), have been implicated in the pathophysiology of heart failure (HF). This study investigated the associations between TMAO, cardiac function, and clinical parameters to evaluate TMAO’s potential as a biomarker for heart failure with reduced ejection fraction (HFrEF). Forty HFrEF patients and forty-one matched healthy controls were recruited for serum TMAO quantification using enzyme-linked immunosorbent assay (ELISA). Associations were examined using Spearman correlation and regression models. TMAO levels were significantly elevated in HFrEF patients (3.64 µM IQR 3.00–4.31) compared with controls (1.22 µM IQR 0.92–2.36) (p < 0.05). Elevated TMAO correlated with impaired cardiac structural and functional parameters, as well as lower serum albumin. Multinomial regression revealed that both TMAO (OR 1.83, 95% CI 1.04–3.23, p = 0.036; OR 2.05, 95% CI 1.18–3.57, p = 0.010, respectively) and albumin (OR 0.56, 95% CI 0.36–0.89, p = 0.015; OR 0.61, 95% CI 0.39–0.93, p = 0.022, respectively) were independently associated with HFrEF severity, showing significant correlations in both mildly (EF 30–40%) and moderately (20–30%) reduced EF groups. Receiver operating characteristic (ROC) analyses showed that TMAO had good discriminative ability for HFrEF (AUC = 0.853), and it improved when combined with clinical covariates (AUC = 0.967), supporting its role as a potential biomarker. These findings support integrating this gut-derived metabolite and nutritional marker into HFrEF risk stratification frameworks.
Kuan et al. (Fri,) reported a other. Elevated TMAO levels (3.64 µM) were significantly associated with HFrEF and correlated with cardiac function parameters and severity (AUC = 0.853).