Untargeted Metabolomics Study Of Coronary Vein And Left Atrium Plasma In Patients With Atrial Fibrillation

Objective:Atrial fibrillation(AF)is a common clinical arrhythmia that causes a series of adverse consequences such as ischemic stroke and heart failure.In clinical practice,the diagnosis of asymptomatic atrial fibrillation and paroxysmal atrial fibrillation is difficult,and there is a lack of exact biological markers.The rapid and disordered electrical activity of atrial fibrillation causes changes in cardiac metabolism,and the specific mechanism is unknown.This study aims to verify the differential metabolites of coronary venous plasma and left atrial plasma in patients with atrial fibrillation and non-atrial fibrillation patients through non-targeted metabolomics methods,to find biological markers that assist in the diagnosis of atrial fibrillation,and to explore the pathology of atrial fibrillation Metabolic pathways involved in physiological changes.Method:A total of Thirty-three patients with nonvalvular atrial fibrillation who were admitted to the Department of Cardiology of the First Affiliated Hospital of Kunming Medical University from June 2019 to June 2020 and planned to atrial fibrillation radiofrequency ablation or cryoablation were included in the case group,and total of Twenty-one patients with accessory pathway located in the mitral valve annulus or premature ventricular contractions originating from the left ventricular and aorta who were planned for radiofrequency ablation served as the control group.The non-targeted metabolomics based on UHPLC-QTOF-MS platform obtains the serum metabolite information of the atrial fibrillation group and the non-atrial fibrillation group,and further metabolite differential analysis,diagnostic tests and bioinformatics channel enrichment to screen the coronary venous plasma and left atrial plasma of patients with atrial fibrillation.Differential metabolites in patients with atrial fibrillation,looking for potential biological markers to evaluate the diagnostic value,exploring the metabolic pathways related to atrial fibrillation,and further searching for potential therapeutic targets.Results:1.546 different metabolites between the atrial fibrillation group and the non-atrial fibrillation group were identified.Among them,the differential metabolites of the coronary sinus plasma sample from the atrial fibrillation group and the non-atrial fibrillation group included 413 types,and the left atrial plasma sample group had 423 different metabolites.There were 36 different metabolites in left atrium and coronary vein plasma in the case group,and 10 different metabolites in left atrium and coronary vein plasma in the control group.Based on the HMDB database,the difference metabolites are mainly annotated to Carboxylic acids and derivatives,Imidazopyrimidines,Hydroxy acids and derivatives,Organonitrogen compounds,Organooxygen compounds,Fatty Acyls,Purine nucleosides,Cinnamic acids and derivatives.The main different metabolites between coronary sinus plasma atrial fibrillation group and non-atrial fibrillation group include:(1S,4R)-p-Mentha-2,8-dien-1-ol,Asperagenin,N-butylformamide,8-Hy dr oxypurine.The main difference metabolites between the left atrium plasma groups include:Acetyl tributyl citrate,Hydroxyminaline,(S,E)-Zearalenone,N-butylformamide,Ovalicin.The main differences between the left atrium and coronary venous plasma in the atrial fibrillation group are include:alpha-Micropteroxanthin B,Tridecanal,Homodihydrojasmone,Tetrahydrofuran,27-Norcholestanehexol.2.N1-Methyl-2-pyridone-5-carboxamide,N(6)-Methyllysine,8-Hydroxypurin e,Succinyladenosine,D-Glucuronic acid sodium salt monohydrate,Phenylalanyl-Tryptophan,Alanylglycine,1-(beta-D-Glucopyranosyloxy)-3-octanon e can distinguish atrial fibrillation from non-atrial fibrillation.3.Highly enriched in different metabolites between atrial fibrillation and non-atrial fibrillation groups are Arginine and proline metabolism,Bile secretion,Nicotinate and nicotinamide metabolism,Valine,leucine and isoleucine biosynthesis,Prodigiosin biosynthesis,Chloroalkane and chloroalkene degradation,Cholesterol metabolism.Synthesis and degradation of ketone bodies,Glyoxylate and dicarboxylate metabolism,Carbon metabolism,Chloroalkane and chloroalkene degradation,Citrate cycle,Butanoate metabolism,Glucagon signaling pathway,Aldosterone-regulated sodium reabsorptionis are highly enriched in the different metabolites in the atrial fibrillation group.Conclusions:1.There are differential metabolites between coronary vein and left atrial plasma in patients with atrial fibrillation and non-atrial fibrillation,and some of the differential metabolites are expected to be used as biomarkers to atrial fibrillation;2.Arginine and proline metabolic pathways,nicotinate and niacinamide metabolic pathways,bile secretion pathways,ketone body synthesis and degradation pathways,etc.may be involved in the pathophysiological mechanism of atrial fibrillation;...