Application of fragmented QRS combined with plasma differential metabolites in early diagnosis of acute myocardial infarction
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摘要: 目的:研究QRS碎裂波结合血浆差异代谢物在急性心肌梗死早期诊断中的作用。方法:通过已建立的血浆非靶向代谢组学方法从健康受试者与急性心肌梗死患者样本中筛选出差异代谢物。利用KEGG数据库对代谢紊乱途径进行分析,通过ROC曲线分析血浆差异代谢物及其结合QRS碎裂波区分健康受试者与急性心肌梗死患者的诊断效能。结果:通过非靶向代谢组学分析,从健康受试者与急性心肌梗死患者血浆样本中筛选出18个差异代谢物,包含脂肪酰胺类、氨基酸类以及甘油磷酯类物质,主要与丙氨酸、天冬氨酸和谷氨酸代谢通路、三羧酸循环通路以及色氨酸代谢通路等紊乱相关。血浆代谢差异物诊断区分健康受试者与急性心肌梗死患者的ROC曲线下面积(AUC)为0.881,灵敏度和特异性分别为78.7%和85.2%;血浆差异代谢物结合QRS碎裂波诊断区分健康受试者与急性心肌梗死患者的AUC为0.943,灵敏度和特异性分别为84.6%和91.3%。结论:QRS碎裂波与血浆差异代谢物相结合,能够提高急性心肌梗死的早期诊断率。Abstract: Objective:To study the role of fragmented QRS combined with plasma differential metabolites in early diagnosis of acute myocardial infarction(AMI).Method:An untargeted metabolomics was performed for detection of plasma differential metabolites between healthy and AMI by the established method previously.The disturbed metabolic pathways were identified by KEGG database according to the differential metabolites in plasma.ROC curve was used to analyze the diagnostic efficiency of plasma differential metabolites and plasma metabolites combined with fragmented QRS between healthy and AMI.Result:Through non-target metabolomics analysis,a total of 18 differential metabolites were screened from healthy and AMI.The classification of 18 differential metabolites in plasma were mainly belong to fatty Acyls,amino acid and glycerophospholipids,and the perturbed metabolic pathways were related to alanine,aspartate and glutamate metabolism,TCA cycle and tryptophan metabolism.The panel consisting of 18 differential metabolites detected the diagnostic performance in the comparison of healthy and AMI patients with the calculated area under curve(AUC) of 0.881(sensitivity:78.7%,Specificity:85.2%).The plasma metabolites combined with fragmented QRS detected the diagnostic performance in the comparison of Healthy against AMI with the AUC of 0.943(sensitivity:84.6%,Specificity:91.3%).Conclusion:Fragmented QRS combined with plasma differential metabolites could improve the early diagnosis rate of acute myocardial infarction.
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Key words:
- fragmented QRS /
- differential metabolites /
- metabolomics /
- plasma
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