Cardiac resynchronization therapy induces adaptive metabolic transitions in the metabolomic profile of heart failure.
Cardiac resynchronization therapy induces adaptive metabolic transitions in the metabolomic profile of heart failure.
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DOI：
10.1016/j.cardfail.2015.04.005
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发表时间：
2015-06
影响因子：
6
通讯作者：
Cha, Yong-Mei
中科院分区：
文献类型：
--
作者：
Nemutlu, Emirhan;Zhang, Song;Xu, Yi-Zhou;Terzic, Andre;Zhong, Li;Dzeja, Petras D.;Cha, Yong-Mei
心力衰竭（HF）与心室不同步和能量效率低下有关，心脏起搏治疗（CRT）可以缓解心力衰竭。本研究的目的是确定HF的代谢组学特征及其对CRT反应的预后价值。这项前瞻性研究包括24例接受CRT治疗晚期HF的患者和10例接受导管消融治疗室上性心律失常但未接受CRT的对照患者。分别于CRT治疗前和治疗后3个月采集血样。采用气相色谱-质谱法和核磁共振法对血浆样本进行代谢组学分析。HF患者的血浆代谢组学特征发生了改变，出现了一组不同的代谢物，包括克雷布斯循环和脂质、氨基酸和核苷酸代谢。CRT改善了代谢特征。琥珀酸/谷氨酸比值（Krebs循环活性指数）从0.58±0.13提高到2.84±0.60（P<0.05）。糖酵解和脂肪酸代谢之间平衡的指标葡萄糖/棕榈酸比率从0.96±0.05增加到1.54±0.09（P<0.01）。与CRT无应答者相比，CRT应答者有明显的基线血浆代谢谱，包括基线时较高的异亮氨酸、苯丙氨酸、亮氨酸、葡萄糖和缬氨酸水平以及较低的谷氨酸水平（P<0.05）。CRT改善了HF患者的血浆代谢谱，表明心肌能量底物代谢的协调。CRT应答者可能具有有利的代谢特征，可作为预测CRT结局的潜在生物标志物。
Heart failure (HF) is associated with ventricular dyssynchrony and energetic inefficiency, which can be alleviated by cardiac resynchronization therapy (CRT). The aim of this study was to determine the metabolomic signature in HF and its prognostic value for the response to CRT. This prospective study consisted of 24 patients undergoing CRT for advanced HF and 10 control patients who underwent catheter ablation for supraventricular arrhythmia but not CRT. Blood samples were collected before and 3 months after CRT. Metabolomic profiling of plasma samples was performed using gas chromatography–mass spectrometry and nuclear magnetic resonance. The plasma metabolomic profile was altered in the HF patients, with a distinct panel of metabolites, including Krebs cycle and lipid, amino acid, and nucleotide metabolism. CRT improved the metabolic profile. The succinate/glutamate ratio, an index of Krebs cycle activity, improved from 0.58±0.13 to 2.84±0.60 (P<.05). The glucose/palmitate ratio, an indicator of the balance between glycolytic and fatty acid metabolism, increased from 0.96±0.05 to 1.54±0.09 (P<.01). Compared with the nonresponders to CRT, the responders had a distinct baseline plasma metabolomic profile, including higher isoleucine, phenylalanine, leucine, glucose, and valine levels and lower glutamate levels at baseline (P<.05). CRT improves plasma metabolomic profile of HF patients indicating harmonization of myocardial energy substrate metabolism. CRT responders may have a favorable metabolic profile as a potential biomarker for predicting CRT outcome.
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影响因子：
20.1
作者：
Doenst T;Nguyen TD;Abel ED
通讯作者：
Abel ED
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作者：
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20.1
作者：
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通讯作者：
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作者：
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通讯作者：
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