Analysis of the relationship between plasma carnitine levels and non-valvular atrial fibrillation

Abstract

Abstract Objective To investigate the correlation between plasma carnitine levels and atrial fibrillation and its predictive value in atrial fibrillation by analyzing the changes of plasma carnitine levels in patients with atrial fibrillation (AF) by metabolomics methods. Methods The clinical data of consecutive patients with non-valvular atrial fibrillation admitted to the Second Hospital of Dalian Medical University from January 2020 to January 2022 and patients with sinus rhythm admitted for other reasons during the same period were collected, and the relationship between plasma carnitine levels and atrial fibrillation was investigated by analyzing the general clinical characteristics (including age, sex, blood pressure, blood lipids, body mass index, history of smoking, history of alcohol consumption, blood uric acid, left atrial internal diameter, history of hypertension, history of cerebral infarction, history of coronary artery disease) and laboratory test results such as plasma carnitine levels in both groups. Results In our study, a total of 195 patients were included in this study, including 90 patients in the atrial fibrillation group (including 45 patients with paroxysmal atrial fibrillation and 45 patients with persistent atrial fibrillation) and 105 patients in the sinus rhythm group. The plasma free carnitine CO, acetyl carnitine C2, propionyl carnitine C3, butyryl carnitine C4, isovaleryl carnitine C5, hydroxyisovaleryl carnitine C5-OH, palmitoyl carnitine C16, octadecanoyl carnitine C18, and 26-carbonyl carnitine C26 were significantly higher in the atrial fibrillation group than in the sinus rhythm group, and the differences were statistically significant (P < 0.05). The plasma acetylcarnitine C2, hydroxybutyrylcarnitine C4-OH, palmitoylcarnitine C16, and hydroxypalmitoylcarnitine C16:1-OH levels were significantly higher in the persistent AF group than in the paroxysmal AF group, and the differences were statistically significant (P < 0.05). Binary logistic regression analysis revealed that age, high-density lipoprotein, left atrial internal diameter, and free carnitine CO were independent risk factors for the development of atrial fibrillation. Conclusion Patients with atrial fibrillation have altered plasma levels of some carnitine, and the occurrence of atrial fibrillation may be related to disturbances in the metabolism of this part of carnitine. Free carnitine CO is an independent correlate of atrial fibrillation, and its elevated levels suggest that patients may be prone to atrial fibrillation.