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Transmethylamine-N-Oxide Is Associated With Diffuse Cardiac Fibrosis in People Living With HIV.

Publication ,  Journal Article
Colaco, NA; Wang, TS; Ma, Y; Scherzer, R; Ilkayeva, OR; Desvigne-Nickens, P; Braunwald, E; Hernandez, AF; Butler, J; Shah, SH; Shah, SJ; Hsue, PY
Published in: J Am Heart Assoc
August 17, 2021

Background People living with HIV are at increased risk of developing diastolic dysfunction, heart failure, and sudden cardiac death, all of which have been characterized by higher levels of myocardial fibrosis. Transmethylamine-N-oxide (TMAO), a dietary gut metabolite, is linked to the development of myocardial fibrosis in animal models. However, it is unclear whether TMAO plays a role in the development of myocardial fibrosis in people living with HIV. Methods and Results The study population consisted of participants enrolled in the multisite cross-sectional study called CHART-HIV (Characterizing Heart Function on Anti-Retroviral Therapy). Participants underwent echocardiography, cardiac magnetic resonance imaging, biomarker analysis, and targeted assessment of gut-related circulating metabolites; diastolic dysfunction was determined by study-specific criteria. Multivariable linear regression models were performed to examine the relationship of gut-related metabolites with serum and imaging measures of myocardial fibrosis. Models were adjusted for traditional cardiovascular, inflammatory, and HIV-related risk factors. Diastolic dysfunction was present in 94 of 195 individuals (48%) in CHART-HIV; this cohort demonstrated higher prevalence of hypertension, hyperlipidemia, and chronic kidney disease as well as higher plasma levels of both TMAO and choline. TMAO levels were associated with parameters reflecting increased left ventricular filling pressures and with a marker of the innate immune system. TMAO levels correlated with diffuse myocardial fibrosis (R=0.35; P<0.05) as characterized by myocardial extracellular volume fraction as well as biomarkers reflective of myocardial fibrosis. Conclusions In this study of people living with HIV, the gut metabolite TMAO was associated with underlying diffuse myocardial fibrosis and found to be a potential marker of early structural heart disease. The mechanistic role of the gut microbiome in HIV-associated cardiovascular disease warrants further investigation. Registration URL: https://clinicaltrials.gov; Unique identifier: NCT02860156.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

August 17, 2021

Volume

10

Issue

16

Start / End Page

e020499

Location

England

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Predictive Value of Tests
  • Myocardium
  • Middle Aged
  • Methylamines
  • Male
  • Humans
  • HIV Long-Term Survivors
 

Citation

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ICMJE
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Colaco, N. A., Wang, T. S., Ma, Y., Scherzer, R., Ilkayeva, O. R., Desvigne-Nickens, P., … Hsue, P. Y. (2021). Transmethylamine-N-Oxide Is Associated With Diffuse Cardiac Fibrosis in People Living With HIV. J Am Heart Assoc, 10(16), e020499. https://doi.org/10.1161/JAHA.120.020499
Colaco, Nalini A., Teresa S. Wang, Yifei Ma, Rebecca Scherzer, Olga R. Ilkayeva, Patrice Desvigne-Nickens, Eugene Braunwald, et al. “Transmethylamine-N-Oxide Is Associated With Diffuse Cardiac Fibrosis in People Living With HIV.J Am Heart Assoc 10, no. 16 (August 17, 2021): e020499. https://doi.org/10.1161/JAHA.120.020499.
Colaco NA, Wang TS, Ma Y, Scherzer R, Ilkayeva OR, Desvigne-Nickens P, et al. Transmethylamine-N-Oxide Is Associated With Diffuse Cardiac Fibrosis in People Living With HIV. J Am Heart Assoc. 2021 Aug 17;10(16):e020499.
Colaco, Nalini A., et al. “Transmethylamine-N-Oxide Is Associated With Diffuse Cardiac Fibrosis in People Living With HIV.J Am Heart Assoc, vol. 10, no. 16, Aug. 2021, p. e020499. Pubmed, doi:10.1161/JAHA.120.020499.
Colaco NA, Wang TS, Ma Y, Scherzer R, Ilkayeva OR, Desvigne-Nickens P, Braunwald E, Hernandez AF, Butler J, Shah SH, Shah SJ, Hsue PY. Transmethylamine-N-Oxide Is Associated With Diffuse Cardiac Fibrosis in People Living With HIV. J Am Heart Assoc. 2021 Aug 17;10(16):e020499.
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

August 17, 2021

Volume

10

Issue

16

Start / End Page

e020499

Location

England

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Predictive Value of Tests
  • Myocardium
  • Middle Aged
  • Methylamines
  • Male
  • Humans
  • HIV Long-Term Survivors