{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:13:55Z","timestamp":1790057635753,"version":"4.0.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,3,9]]},"abstract":"\n Background<\/jats:title>\n \n Acute kidney injury (\n AKI<\/jats:styled-content>\n ) occurs commonly after transcatheter aortic valve replacement (\n TAVR<\/jats:styled-content>\n ) and is associated with markedly increased postoperative mortality. We previously identified plasma metabolites predictive of incident chronic kidney disease, but whether metabolite profiles can identify those at risk of\n AKI<\/jats:styled-content>\n is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We performed liquid chromatography\u2013mass spectrometry\u2013based metabolite profiling on plasma from patients undergoing\n TAVR<\/jats:styled-content>\n and subjects from the community\u2010based Framingham Heart Study (N=2164).\n AKI<\/jats:styled-content>\n was defined by using the Valve Academic Research Consortium\u20102 criteria. Of 44 patients (mean age 82\u00b19\u00a0years, 52% female) undergoing\n TAVR<\/jats:styled-content>\n , 22 (50%) had chronic kidney disease and 9 (20%) developed\n AKI<\/jats:styled-content>\n . Of 85 metabolites profiled, we detected markedly concordant cross\u2010sectional metabolic changes associated with chronic kidney disease in the hospital\u2010based\n TAVR<\/jats:styled-content>\n and Framingham Heart Study cohorts. Baseline levels of 5\u2010adenosylhomocysteine predicted\n AKI<\/jats:styled-content>\n after\n TAVR<\/jats:styled-content>\n , despite adjustment for baseline glomerular filtration rate (odds ratio per 1\u2010\n SD<\/jats:styled-content>\n increase 5.97, 95%\n CI<\/jats:styled-content>\n 1.62\u201322.0;\n P<\/jats:italic>\n =0.007). Of the patients who had\n AKI<\/jats:styled-content>\n , 6 (66.7%) subsequently died, compared with 3 (8.6%) deaths among those patients who did not develop\n AKI<\/jats:styled-content>\n (\n P<\/jats:italic>\n =0.0008) over a median follow\u2010up of 7.8\u00a0months. 5\u2010adenosylhomocysteine was predictive of all\u2010cause mortality after\n TAVR<\/jats:styled-content>\n (hazard ratio per 1\u2010\n SD<\/jats:styled-content>\n increase 2.96, 95%\n CI<\/jats:styled-content>\n 1.33\u20136.58;\n P<\/jats:italic>\n =0.008), independent of baseline glomerular filtration rate.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In an elderly population with severe aortic stenosis undergoing\n TAVR<\/jats:styled-content>\n , metabolite profiling improves the prediction of\u00a0AKI. Given the multifactorial nature of\n AKI<\/jats:styled-content>\n after\n TAVR<\/jats:styled-content>\n , metabolite profiles may identify those patients with reduced renal reserve.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002712","type":"journal-article","created":{"date-parts":[[2016,3,16]],"date-time":"2016-03-16T02:53:41Z","timestamp":1458096821000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Metabolite Profiles Predict Acute Kidney Injury and Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement"],"prefix":"10.1161","volume":"5","author":[{"given":"Sammy","family":"Elmariah","sequence":"first","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA"},{"name":"Harvard Clinical Research Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie A.","family":"Farrell","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Daher","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Shi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J.","family":"Keyes","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn H.","family":"Cain","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Pomerantsev","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gus J.","family":"Vlahakes","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Inglessis","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J.","family":"Passeri","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor F.","family":"Palacios","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline S.","family":"Fox","sequence":"additional","affiliation":[{"name":"Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA"},{"name":"Endocrinology Division, Brigham & Women's Hospital, Boston, MA"},{"name":"Division of Intra\u2010mural Research, National Heart, Lung, and Blood Institute, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene P.","family":"Rhee","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA"},{"name":"Nephrology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Gerszten","sequence":"additional","affiliation":[{"name":"Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA"},{"name":"Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, 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