Rapid and sensitive determination of carnitine profiling by tandem mass spectrometry can be a diagnostic marker of paroxysmal atrial fibrillation

DOI: 10.4328/JCAM.5815 Received: 13.03.2018 Accepted: 29.03.2018 Published Online: 02.04.2018 Printed: 01.09.2018 J Clin Anal Med 2018;9(5): 447-51 Corresponding Author: İsmail Koyuncu, Harran University, Faculty of Medicine, Department of Medical Biochemistry, Şanlıurfa, Türkiye. T.: +90 414 3183209 F.: +90 4143183208 E-Mail: ismailkoyuncu1@gmail.com ORCID ID: 0000-0002-9469-4757 Abstract Aim: Paroxysmal atrial fibrillation (PAF), which is in the sub-group of atrial fibrillation that spontaneously resolves within 48 hours and does not last more than 7 days, is one of the most important causes of cryptogenic stroke. Other than ECG findings, there are no biochemical diagnostic criteria for PAF. Early diagnosis of PAF reduces the risk of morbidity and mortality. Therefore, it is important to identify new diagnostic markers. Metabolomics methods have recently started to be used for this purpose. Carnitine profiling with LC-MS/MS is a fast, inexpensive metabolomics screening method with high sensitivity and has started to be used for the determination of new diagnostic markers. The aim of this study was to investigate the viability of the carnitine profile as a new biochemical marker supporting diagnosis in PAF patients. Material and Method: A total of 27 carnitine ester profiles were examined with the LC-MS/MS method using serum samples taken from 41 patients diagnosed with PAF from ECG findings and 42 healthy individuals with sinus rhythm. Results: The C14, C16:1, and C18:1 serum carnitine ester levels of the PAF patients were determined to be statistically significantly higher than those of the healthy control group (p<0.05) and C6DC levels were found to be significantly lower (p<0.05). Discussion: The results of the study strengthened the view that with measurements made with LCMS/MS, the carnitine profile, which is an inexpensive, sensitive reference method, can be used as an objective biochemical test to support diagnosis.