Dietary-Associated Trimethylamine N-Oxide (TMAO) Levels Is associated With Coronary Allograft Vasculopathy Following Heart Transplantation
1Cellular and Molecular Medicine, Cleveland Clinic, Cleveland, OH
2Transplant Center, Cleveland Clinic, Cleveland, OH
3Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH.
Meeting: 2015 American Transplant Congress
Abstract number: C234
Keywords: Graft arterlosclerosis, Heart transplant patients
Session Information
Session Name: Poster Session C: Translational Biomarkers and Immune Monitoring
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Background: Coronary allograft vasculopathy (CAV) is a leading cause of cardiac graft failure after 1 year post transplant. It is characterized by an inflammatory vascular process with underlying endothelial damage. Our group has recently discovered that gut microbiota-dependent formation of trimethylamine-N-oxide (TMAO) is mechanistically linked to cardiovascular disease (CVD) pathogenesis. Whether this process underlies the development of CAV is unknown.
Methods: We conducted a single center retrospective cohort study of 225 heart transplant recipients between 2009-2014 with serum samples collected as well as clinical and angiographic data available. Fasting TMAO was measured by liquid chromatography tandem mass spectrometry.
Results: In our cohort study, 75% of patients were males with mean age of 56.2±0.84 years, serum samples were collected at mean of 3.0±0.3 years post-transplant. 62 recipients (28%) had angiographic evidence of CAV. Compared to those without CAV, patients with CAV had similar rates of acute rejection (50% vs. 56%), CMV positive status (74% vs. 80%), dyslipidemia (50% vs. 39%) and hypertension (52% vs. 50%), but were more likely to be diabetic (53% vs. 37% p=0.035). Recipients with CAV had higher serum TMAO than those without CAV (median 7.2 [IQR: 4.5-15.2] ¯o;M vs 5.9 [IQR: 3.5-10.4] ¯o;M; p=0.001). Furthermore, a TMAO cutoff value of 6 ¯o;M or above was predictive of CAV development (OR: 1.9, 95% CI: 1.06, 3.54).
Conclusion: Elevated circulating TMAO level is associated with the presence of CAV in heart transplant recipients.
To cite this abstract in AMA style:
Zeltzer S, Wang Z, Askar M, Coughlin J, Hudec T, Taylor D, Li L, Starling R, Hazen S, Tang W. Dietary-Associated Trimethylamine N-Oxide (TMAO) Levels Is associated With Coronary Allograft Vasculopathy Following Heart Transplantation [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/dietary-associated-trimethylamine-n-oxide-tmao-levels-is-associated-with-coronary-allograft-vasculopathy-following-heart-transplantation/. Accessed October 11, 2024.« Back to 2015 American Transplant Congress