URV researchers have studied the association between the metabolism of this molecule, choline, and the emergence of two cardicac pathologies: atrial fibrillation and cardiac insufficiency. These results may help to determine some biomarkers that predict certain cardiovascular diseases

In the context of the PREDIMED study (Prevención con dieta Mediterránea) researchers from the Rovira i Virgili University (URV) have investigated the association between the circulating levels of different molecules related to the metabolism of choline (trimethylamine-N-oxide (TMAO), choline, betaine, dimethylglycine and L-carnitine) and the risk of onset, approximately 10 years later, of two cardiac pathologies: atrial fibrillation (AF) – one of the most frequent and lethal cardiac arrhythmias – and heart failure (HF) – inability of the heart to pump blood properly -. The results of this study have just been published in the scientific journal Clinical Chemistry. These results may help determine biomarkers that predict certain cardiovascular diseases.

Both AF and HR represent important cardiovascular alterations that contribute to the increase in the social and personal burden of this type of disease, as well as to the increasing costs of medical care worldwide. AF and HF tend to coincide due to the presence of shared cardiometabolic risk factors. However, to better understand their common and / or differentiating pathophysiological processes, it is necessary to examine the relationship between these two alterations and new risk factors. In this sense, the identification of putative markers or “metabolites” that reflect pathophysiological processes related to AF and HF, would help to identify those individuals who are at risk of developing AF or HF, and thereby establish early preventive measures.

TMAO is considered an interesting metabolite for the scientific community, since it has been linked to cardiovascular diseases as well as other pathologies. However, until now it was not known whether TMAO or its precursors could be involved in altered metabolic pathways that contribute to the risk of AF and HF. In order to increase knowledge in this area, researchers from Rovira i Virgili University in collaboration with the Universities of Harvard and Navarra evaluated, in the context of the PREDIMED study, the associations between plasma concentrations of TMAO and its precursors, with risk of development of these two cardiac abnormalities (509 cases of AF and 326 cases of HF) after several years of follow-up. The researchers identified positive associations between the levels of choline, betaine and dimethylglycine, but not in the case of TMAO and L-carnitine, with risk of both AF and incident HF, therefore the metabolic pathway of choline is now at the focus of future research.

According to Jordi Salas-Salvadó “If these findings are corroborated in future studies carried out in the framework of other populations, we could possibly better predict these diseases and establish future therapeutic strategies”.

The study coordinated by the Human Nutrition Unit of the URV-IISPV (Instituto de Investigación Sanitaria Pere Virgili) of the Department of Biochemistry and Biotechnology of the URV, is part of a project of the National Institute of Health (NIH) of the United States, in which the University of Navarra, Harvard University, the Broad Institute of the USA and the rest of the PREDIMED consortium also collaborate. This research has been carried out by Doctor Christopher Papandreou, researcher at the IISPV, and coordinated by Professor Jordi Salas-Salvadó, also a member of the IISPV, director of the Human Nutrition Unit of the URV, Clinical Director of Nutrition in the Medicine Service Intern at the Sant Joan University Hospital in Reus and principal investigator of the Center for Biomedical Research in Network of Physiopathology of Obesity and Nutrition (CIBERobn).

Reference: Christopher Papandreou, Mònica Bulló, Pablo Hernández-Alonso, Miguel Ruiz-Canela, Jun Li, Marta Guasch-Ferré, Estefanía Toledo, Clary Clish, Dolores Corella, Ramon Estruch, Emilio Ros, Montserrat Fitó, Angel Alonso-Gómez, Miquel Fiol, José M Santos-Lozano, Lluís Serra-Majem, Liming Liang, Miguel A Martínez-González, Frank B Hu, Jordi Salas-Salvadó, Choline Metabolism and Risk of Atrial Fibrillation and Heart Failure in the PREDIMED Study, Clinical Chemistry, , hvaa224, https://doi.org/10.1093/clinchem/hvaa224