Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart Failure
Exhaled breath volatile organic compounds (VOCs) are elevated in heart failure (HF). The ability of VOCs to predict long term cardiovascular mortality and morbidity has not been independently verified. In 55 patients admitted with acute decompensated heart failure (ADHF), we measured exhaled breath...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Metabolites |
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| Online Access: | https://www.mdpi.com/2218-1989/13/10/1049 |
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| author | Wai Hong Wilson Tang Lily Tranchito Chonyang Albert Zeynep G. Gul Frank S. Cikach David Grove Yuping Wu Raed A. Dweik |
| author_facet | Wai Hong Wilson Tang Lily Tranchito Chonyang Albert Zeynep G. Gul Frank S. Cikach David Grove Yuping Wu Raed A. Dweik |
| author_sort | Wai Hong Wilson Tang |
| collection | DOAJ |
| description | Exhaled breath volatile organic compounds (VOCs) are elevated in heart failure (HF). The ability of VOCs to predict long term cardiovascular mortality and morbidity has not been independently verified. In 55 patients admitted with acute decompensated heart failure (ADHF), we measured exhaled breath acetone and pentane levels upon admission and after 48 h of diuresis. In a separate cohort of 51 cardiac patients undergoing cardiopulmonary exercise testing (CPET), we measured exhaled breath acetone and pentane levels before and at peak exercise. In the ADHF cohort, admission acetone levels correlated with lower left ventricular ejection fraction (LVEF, r = −0.297, <i>p</i> = 0.035). Greater weight loss with diuretic therapy correlated with a greater reduction in both acetone levels (r = −0.398, <i>p</i> = 0.003) and pentane levels (r = −0.309, <i>p</i> = 0.021). In patients with above-median weight loss (≥4.5 kg), patients demonstrated significantly greater percentage reduction in acetone (59% reduction vs. 7% increase, <i>p</i> < 0.001) and pentane (23% reduction vs. 2% reduction, <i>p</i> = 0.008). In the CPET cohort, admission acetone and pentane levels correlated with higher VE/VCO2 (r = 0.39, <i>p</i> = 0.005), (r = 0.035, <i>p</i> = 0.014). However, there were no significant correlations between baseline or peak exercise acetone and pentane levels and peak VO2. In longitudinal follow-up with a median duration of 33 months, patients with elevated exhaled acetone and pentane levels experienced higher composite adverse events of death, ventricular assist device implantation, or orthotopic heart transplantation. In patients admitted with ADHF, higher exhaled breath acetone levels are associated with lower LVEF and poorer outcomes, and greater reductions in exhaled breath acetone and pentane tracked with greater weight loss. Exhaled acetone and pentane may be novel biomarkers in heart failure worthy of future investigation. |
| first_indexed | 2024-03-10T21:03:55Z |
| format | Article |
| id | doaj.art-b9e33d6ff0da455da1ee9293be418f77 |
| institution | Directory Open Access Journal |
| issn | 2218-1989 |
| language | English |
| last_indexed | 2024-03-10T21:03:55Z |
| publishDate | 2023-10-01 |
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| spelling | doaj.art-b9e33d6ff0da455da1ee9293be418f772023-11-19T17:19:44ZengMDPI AGMetabolites2218-19892023-10-011310104910.3390/metabo13101049Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart FailureWai Hong Wilson Tang0Lily Tranchito1Chonyang Albert2Zeynep G. Gul3Frank S. Cikach4David Grove5Yuping Wu6Raed A. Dweik7Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USAEndocrinology & Metabolism Institute, Cleveland Clinic, Cleveland, OH 44195, USAHeart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Surgery, Washington University School of Medicine at St Louis, St Louis, MO 63110, USAHeart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Inflammation and Immunology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Mathematics, Cleveland State University, Cleveland, OH 44195, USADepartment of Inflammation and Immunology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USAExhaled breath volatile organic compounds (VOCs) are elevated in heart failure (HF). The ability of VOCs to predict long term cardiovascular mortality and morbidity has not been independently verified. In 55 patients admitted with acute decompensated heart failure (ADHF), we measured exhaled breath acetone and pentane levels upon admission and after 48 h of diuresis. In a separate cohort of 51 cardiac patients undergoing cardiopulmonary exercise testing (CPET), we measured exhaled breath acetone and pentane levels before and at peak exercise. In the ADHF cohort, admission acetone levels correlated with lower left ventricular ejection fraction (LVEF, r = −0.297, <i>p</i> = 0.035). Greater weight loss with diuretic therapy correlated with a greater reduction in both acetone levels (r = −0.398, <i>p</i> = 0.003) and pentane levels (r = −0.309, <i>p</i> = 0.021). In patients with above-median weight loss (≥4.5 kg), patients demonstrated significantly greater percentage reduction in acetone (59% reduction vs. 7% increase, <i>p</i> < 0.001) and pentane (23% reduction vs. 2% reduction, <i>p</i> = 0.008). In the CPET cohort, admission acetone and pentane levels correlated with higher VE/VCO2 (r = 0.39, <i>p</i> = 0.005), (r = 0.035, <i>p</i> = 0.014). However, there were no significant correlations between baseline or peak exercise acetone and pentane levels and peak VO2. In longitudinal follow-up with a median duration of 33 months, patients with elevated exhaled acetone and pentane levels experienced higher composite adverse events of death, ventricular assist device implantation, or orthotopic heart transplantation. In patients admitted with ADHF, higher exhaled breath acetone levels are associated with lower LVEF and poorer outcomes, and greater reductions in exhaled breath acetone and pentane tracked with greater weight loss. Exhaled acetone and pentane may be novel biomarkers in heart failure worthy of future investigation.https://www.mdpi.com/2218-1989/13/10/1049exhaled breathselected ion flow tube mass spectrometryacetonepentaneheart failure |
| spellingShingle | Wai Hong Wilson Tang Lily Tranchito Chonyang Albert Zeynep G. Gul Frank S. Cikach David Grove Yuping Wu Raed A. Dweik Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart Failure Metabolites exhaled breath selected ion flow tube mass spectrometry acetone pentane heart failure |
| title | Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart Failure |
| title_full | Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart Failure |
| title_fullStr | Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart Failure |
| title_full_unstemmed | Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart Failure |
| title_short | Exhaled Breath Analysis Using Selected Ion Flow Tube Mass Spectrometry and Disease Severity in Heart Failure |
| title_sort | exhaled breath analysis using selected ion flow tube mass spectrometry and disease severity in heart failure |
| topic | exhaled breath selected ion flow tube mass spectrometry acetone pentane heart failure |
| url | https://www.mdpi.com/2218-1989/13/10/1049 |
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