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Abstract：
BACKGROUND: Previous studies have shown the importance of energy deficiency and malfunctioning mitochondria in the pathophysiology of hypertrophic cardiomyopathy (HCM). There has been a little research into the relationship between plasma free fatty acids (FFA), one of the heart\'s main energy sources, and HCM. We evaluated its clinical importance in HCM to see if there was a link between plasma FFA metabolism and HCM.
METHODS: In a single-center retrospective observational study, we investigated 420 HCM patients diagnosed at Beijing Anzhen Hospital between January 1, 2018, and December 31, 2022. Meanwhile, 1372 individuals without HCM (non-HCM) were recruited. 391 non-HCM patients were chosen as controls via a propensity score matching (PSM) study with a 1:1 ratio.
RESULTS: FFA in HCM patients showed statistically significant correlations with creatinine (r = 0.115, p = 0.023), estimated GFR (r=-0.130, p = 0.010), BNP (r = 0.152, p = 0.007), LVEF (r=-0.227, p < 0.001), LVFS (r=-0.160, p = 0.002), and LAD (r = 0.112, p = 0.028). Higher FFA levels were found in HCM patients who had atrial fibrillation and NYHY functional classes III or IV (p = 0.015 and p = 0.022, respectively). In HCM patients, multiple linear regression analysis revealed that BNP and LVEF had independent relationships with increasing FFA (Standardized = 0.139, p = 0.013 and =-0.196, p < 0.001, respectively).
CONCLUSIONS: Among HCM patients, the plasma FFA concentration was lower, and those with AF and NYHY functional class III or IV had higher FFA levels, and LVEF and BNP were independently associated with increasing FFA. The findings of the study should help inspire future efforts to better understand how energy deficiency contributes to hypertrophic cardiomyopathy (HCM) development.
METHODS: In a single-center retrospective observational study, we investigated 420 HCM patients diagnosed at Beijing Anzhen Hospital between January 1, 2018, and December 31, 2022. Meanwhile, 1372 individuals without HCM (non-HCM) were recruited. 391 non-HCM patients were chosen as controls via a propensity score matching (PSM) study with a 1:1 ratio.
RESULTS: FFA in HCM patients showed statistically significant correlations with creatinine (r = 0.115, p = 0.023), estimated GFR (r=-0.130, p = 0.010), BNP (r = 0.152, p = 0.007), LVEF (r=-0.227, p < 0.001), LVFS (r=-0.160, p = 0.002), and LAD (r = 0.112, p = 0.028). Higher FFA levels were found in HCM patients who had atrial fibrillation and NYHY functional classes III or IV (p = 0.015 and p = 0.022, respectively). In HCM patients, multiple linear regression analysis revealed that BNP and LVEF had independent relationships with increasing FFA (Standardized = 0.139, p = 0.013 and =-0.196, p < 0.001, respectively).
CONCLUSIONS: Among HCM patients, the plasma FFA concentration was lower, and those with AF and NYHY functional class III or IV had higher FFA levels, and LVEF and BNP were independently associated with increasing FFA. The findings of the study should help inspire future efforts to better understand how energy deficiency contributes to hypertrophic cardiomyopathy (HCM) development.
摘要：
背景：先前的研究表明，能量缺乏和线粒体功能障碍在肥厚型心肌病（HCM）的病理生理学中的重要性。关于血浆游离脂肪酸（FFA）之间的关系的研究很少，心脏的主要能量来源之一,和HCM。我们评估了其在HCM中的临床重要性，以了解血浆FFA代谢与HCM之间是否存在联系。
方法：在单中心回顾性观察研究中，我们调查了2018年1月1日至2022年12月31日在北京安贞医院确诊的420例HCM患者.同时,招募了1372名没有HCM（非HCM）的个体。通过1:1比例的倾向评分匹配(PSM)研究选择391名非HCM患者作为对照。
结果：HCM患者的FFA与肌酐具有统计学意义（r=0.115，p=0.023），估计GFR(r=-0.130，p=0.010)，BNP(r=0.152,p=0.007),LVEF（r=-0.227，p<0.001），LVFS（r=-0.160，p=0.002），和LAD(r=0.112,p=0.028)。在患有房颤和NYHY功能III或IV级的HCM患者中发现较高的FFA水平（分别为p=0.015和p=0.022）。在HCM患者中，多元线性回归分析显示，BNP和LVEF与FFA的增加有独立的关系（标准化=0.139，p=0.013和-0.196，p<0.001）。
结论：在HCM患者中，血浆FFA浓度较低，房颤和NYHY功能III级或IV级患者的FFA水平较高，LVEF和BNP与FFA升高独立相关。该研究的结果应有助于激发未来的努力，以更好地了解能量缺乏如何导致肥厚型心肌病（HCM）的发展。
方法：在单中心回顾性观察研究中，我们调查了2018年1月1日至2022年12月31日在北京安贞医院确诊的420例HCM患者.同时,招募了1372名没有HCM（非HCM）的个体。通过1:1比例的倾向评分匹配(PSM)研究选择391名非HCM患者作为对照。
结果：HCM患者的FFA与肌酐具有统计学意义（r=0.115，p=0.023），估计GFR(r=-0.130，p=0.010)，BNP(r=0.152,p=0.007),LVEF（r=-0.227，p<0.001），LVFS（r=-0.160，p=0.002），和LAD(r=0.112,p=0.028)。在患有房颤和NYHY功能III或IV级的HCM患者中发现较高的FFA水平（分别为p=0.015和p=0.022）。在HCM患者中，多元线性回归分析显示，BNP和LVEF与FFA的增加有独立的关系（标准化=0.139，p=0.013和-0.196，p<0.001）。
结论：在HCM患者中，血浆FFA浓度较低，房颤和NYHY功能III级或IV级患者的FFA水平较高，LVEF和BNP与FFA升高独立相关。该研究的结果应有助于激发未来的努力，以更好地了解能量缺乏如何导致肥厚型心肌病（HCM）的发展。
