Koroner Arter Hastalarında Koroner Anjiyografi Öncesi ve Sonrası Karnitin Profilinin İncelenmesi: Karnitin ve Kardiyovasküler Hastalıklar

Adem İnco; Mehmet Salih Aydın; Yasemin Hacanlı

doi:10.5281/zenodo.12574936

Yazarlar

Adem İnco Harran Üniversitesi https://orcid.org/0000-0002-7324-7202
Mehmet Salih Aydın Harran Üniversitesi https://orcid.org/0000-0002-6652-6035
Yasemin Hacanlı Harran Üniversitesi https://orcid.org/0000-0002-4427-8149

DOI:

https://doi.org/10.5281/zenodo.12574936

Anahtar Kelimeler:

Koroner Arter Hastalığı, Karnitin Profili, Koroner Angiyografi, LCMS/MS

Özet

Amaç: Karnitin profilindeki değişiklikler kardiyovasküler hastalıkların patogenezinde rol oynayabilir. Bu çalışma, koroner arter hastaları ile normal bireylerin serbest karnitin profillerini karşılaştırarak kardiyovasküler hastalıkların tanı ve tedavisinde kullanılabilecek yeni belirteçleri belirlemek amacıyla yapılmıştır.

Materyal ve Metot: Çalışmamızda, koroner arter hastalığı tanısı ile hastanemize gelen 25 hasta (tedavi grup) ve 25 sağlıklı gönüllü birey (kontrol grup) olmak üzere toplam 50 birey çalışmaya dâhil edildi. Koroner arter hastalığına sahip 25 bireyin tedavi amaçlı yapılan koroner anjiyografi öncesinde ve sonrasında alınan kuru kan numunelerindeki karnitin profili, sağlıklı 25 bireyden alınan kuru kan karnitin profiliyle karşılaştırıldı. Alınan plazma örneklerinin serbest karnitin profili LCMS8040 cihazı ile karnitin esteri ölçüldü. Sonuçlar istatistiksel olarak değerlendirildi.

Bulgular: Çalışmamızda 27 parametre (C0, C2, C3, C4, C4DC, C5, C5:1, C5OH, C5DC, C6, C6DC, C8, C8:1, C8DC, C10, C10:1, C10DC, C12, C14, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2, C18:1 OH) LCMS/MS ile karnitin esteri ölçüldü. Elde edilen sonuçlara göre; koroner arter hastalarının anjiyografi öncesi grubundaki C0, C2, C3, C4, C4DC, C5, C5:1, C5OH, C5OH, C14 ve C16 değerlerinin ortalamaları kontrol grubuna göre anlamlı düzeyde yüksek bulundu. İstatistiksel olarak anlamlı kabul edildi (p<0,05).

Tartışma ve Sonuç Sonuçlarımıza göre serbest karnitin profilinin koroner arter hastalığının tanı ve tedavisinde kullanılma potansiyeline sahip olduğunu düşünmekteyiz.

Yazar Biyografisi

Adem İnco, Harran Üniversitesi

Harran Üniversitesi, Tıp Fakültesi, Çocuk sağlığı ve Hastalıkları Anabilim Dalı Başkanlığında hemşire olarak çalışmakta. Perfüzyon Bölümü Yüksek lisans mezunu

Referanslar

Shao C, Wang J, Tian J, Tang YD. Coronary Artery Disease: From Mechanism to Clinical Practice. Adv Exp Med Biol. 2020;1177:1-36.

Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–77.

Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart disease and stroke statistics-2021 update: a report from the American Heart Association. Circulation. 2021; 143(8):e254-e743.

Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, et al: 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2012; 60(24):e44-e164.

Stefanini GG, Malanchini G, Sousa-Uva M, Neumann FJ. What's new in the 2018 ESC/EACTS guidelines on myocardial revascularization?. G Ital Cardiol (Rome). 2018;19(11 Suppl 2):5S-9S.

Demir Ö, Arslantaş H. The Effects of Progressive Relaxation Exercises Applied with Music Before Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty on the State and Trait Anxiety of People. Journal of Psychiatric Nursing. 2014;5(3):113-121.

Atabilen B, Yıldıran H. The Use of Carnitine in Hemodialysis Patients. Turk Neph Dial Transpl. 2017;26(3):246-253.

La Marca G, Malvagia S, Pasquini E, Innocenti M, Fernandez MR, Donati MA, et al. The inclusion of succinylacetone as marker for tyrosinemia type i in expanded newborn screening programs. Rapid Commun Mass Spectrom. 2008;22(6):812-8.

Azzari C, La Marca G, Resti M. Neonatal screening for severe combined immunodeficiency caused by an adenosine deaminase defect: a reliable and inexpensive method using tandem mass spectrometry. J. of Allergy and Clinical Immunology. 2011;127(6):1394-9.

Rasmussen J, Duno M, Lund AM, Steuerwald U,Hansen SH, Joensen HD, et al. Increased risk of sudden death in untreated primary carnitine deficiency. J Inherit Metab Dis. 2020;43(2):290‐96.

Crefcoeur LL, Melles MC, Bruning TA, Pereira RR, Langendonk JG. Primary carnitine deficiency is a life-long disease. JIMD Rep. 2022;63(6):524-28.

Trupp RJ, Abraham WT. Congestive heart failure. In: Rakel RE, Bope ET, eds, Rakel: Conn’s Current Therapy. 54th ed. New York, WB. Saunders Company. 2002.pp.306-313

Wang ZY, Liu YY, Liu GH, Lu HB, Mao CY. l-Carnitine and heart disease. Life Sci. 2018;194:88-97.

Hu Z, Zhu Z, Cao Y, Wang L, Sun X, Dong J, et.al. Rapid and sensitive differentiating ischemic and hemorrhagic strokes by dried blood spot based direct injection mass spectrometry metabolomics analysis. Journal of clinical laboratory analysis. 2016;30(6):823-30.

Morris CR, Agin, MC. Syndrome of allergy, apraxia, and malabsorption: characterization of a neurodevelopmental phenotype that responds to omega 3 and vitamin E supplementation. Alternative Therapies in Health & Medicine. 2009;15(4):34.

Koyuncu İ, Gonel A. Rapid and sensitive determination of carnitine profiling by tandem mass spectrometry can be a diagnostic marker of paroxysmal atrial fibrillation. Journal of Clınıcal and Analytıcal Medicine. 2018;9(5):447-51.

Broderick TL, Quinney HA, Barker CC, Lopaschuk GD. Beneficial effect of carnitine on mechanical recovery of rat hearts reperfused after a transient period of global ischemia is accompanied by a stimulation of glucose oxidation. Circulation. 1993;87(3): 972-81.

Goetzman ES. Advances in the Understanding and Treatment of Mitochondrial Fatty Acid Oxidation Disorders. Current Genetic Medicine Reports. 2017;5(3):132-42.

Mondillo S, Faglia S, D'Aprile N, Mangiacotti L, Campolo MA, Palazzuoli V. Therapy of arrhythmia induced by myocardial ischemia. Association of L-carnitine, propafenone and mexiletine. La Clinica Terapeutica. 1995;146(12):769-74.

Hunter WG, Kelly JP, McGarrah 3rd RW, Khouri MG, Craig D, Haynes C, et.al. Metabolomic profiling identifies novel circulating biomarkers of mitochondrial dysfunction differentially elevated in heart failure with preserved versus reduced ejection fraction: evidence for shared metabolic impairments in clinical heart failure. J Am Heart Assoc. 2016;5(8): e003190.

Dikme R, Padak M, Işık M, Koyuncu İ, Temiz E, Aydın MS, et al. Soluble ST2 as a Potential Biomarker in Pericardial Fluid of Coronary Artery Patients. Braz J Cardiovasc Surg. 2021;36(5):677-684.

Malakar AK, Choudhury D, Halder B, Paul P, Uddin A, Chakraborty S. A review on coronary artery disease, its risk factors, and therapeutics. J Cel physiol, 2019;234(10):16812.