Key result
Higher plasma TMAO linked to ~249% greater HFpEF risk and increased renal dysfunction.
Why the study?
Renal dysfunction in HFpEF is associated with worse outcomes, but rapid, noninvasive, and accurate methods for risk stratification are lacking.
Are plasma TMAO levels associated with the presence of HFpEF and renal dysfunction?
Cross-Sectional (n=324)
No
Are plasma TMAO levels associated with the presence of HFpEF and renal dysfunction?
Effect estimate: OR 3.49 (95% CI 1.23-9.86)
p-value: p=0.02
Plasma TMAO levels are elevated in HFpEF and independently associated with both the presence of HFpEF and concurrent renal dysfunction, suggesting its potential utility as a diagnostic biomarker.
TMAO was associated with prevalent HFpEF and renal dysfunction; leaves open its value as a biomarker pending prospective studies.
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is an emerging global health problem with less awareness. Renal dysfunction in HFpEF is associated with worse outcome. However, there is lack of rapid, noninvasive and accurate method for risk stratification in HFpEF and renal dysfunction. This study aimed to explore the utility of plasma trimethylamine n-oxide (TMAO) for evaluation of HFpEF and renal function. METHODS: Plasma TMAO levels were measured in total 324 subjects comprising 228 HFpEF patients and 96 healthy controls. RESULTS: ) (14.18(10.4-23.06) μg/l vs 10.9(7.48-15.47) μg/l, p < 0.01). Increased TMAO levels were independently associated with higher risk of HFpEF (OR = 3.49, 95% CI: 1.23-9.86, p = 0.02) and renal dysfunction (OR = 9.57, 95% CI: 2.11-43.34, p < 0.01) after adjustment for multiple traditional risk factors. Furthermore, TMAO had good performance at distinguishing HFpEF from controls (AUC = 0.63, p < 0.01), and renal dysfunction from normal renal function in HFpEF (AUC = 0.67, p < 0.01). CONCLUSION: In this cross-sectional study, HFpEF and renal function were closely related with plasma TMAO levels and TMAO may serve as a diagnostic biomarker for HFpEF and renal function.
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Guo et al. (2020) conducted a cross-sectional in Heart failure with preserved ejection fraction (HFpEF) (n=324). Plasma trimethylamine n-oxide (TMAO) vs. Healthy controls was evaluated on Risk of HFpEF (OR 3.49, 95% CI 1.23-9.86, p=0.02). Increased plasma TMAO levels were independently associated with a higher risk of HFpEF (OR 3.49) and renal dysfunction (OR 9.57) after adjustment for multiple traditional risk factors.
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