Circulating metabolite profiles to predict response to cardiac resynchronization therapy
Circulating metabolite profiles to predict response to cardiac resynchronization therapy
复制标题
循环代谢物谱可预测心脏再同步治疗的反应
DOI：
10.1186/s12872-020-01443-y
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发表时间：
2020-04-16
影响因子：
2.1
通讯作者：
Ge，Junbo
中科院分区：
文献类型：
--
作者：
Gong，Xue;Sun，Zhonghan;Ge，Junbo
背景心力衰竭（heartfailure，心衰）伴随心室运动不同步和能量不足，心脏复律治疗（cardiac embolization therapy，CRT）可缓解心衰，无反应率约为1/3。到目前为止，还没有特异性的生物标志物来预测心力衰竭患者对CRT的反应。在这项研究中，我们评估的作用，血液代谢谱预测的反应CRT。MethodsA共105例扩张型心肌病患者严重心力衰竭接受CRT被列入我们的两个阶段的研究。在CRT植入前采集基线血样。根据超声心动图标准定义CRT反应。结果17种代谢物在应答者和非应答者之间的水平存在显著差异，这些代谢物主要参与亚油酸代谢、缬氨酸、亮氨酸和异亮氨酸生物合成、苯丙氨酸代谢、柠檬酸循环、色氨酸代谢、和鞘脂代谢。异亮氨酸、色氨酸和亚油酸的组合被确定为理想的代谢物组，以区分发现集中的应答者和非应答者。（n= 51，AUC为0.981），并且在验证集中得到了证实（n= 54，AUC为0.929）结论基于质谱技术的血清代谢组学方法能够提供更大范围的代谢组学信息，有助于区分CRT应答者和非应答者。异亮氨酸、色氨酸和亚油酸的组合可能与CRT的显著预后价值相关。
BackgroundHeart failure is associated with ventricular dyssynchrony and energetic inefficiency, which can be alleviated by cardiac resynchronization therapy (CRT) with approximately one-third of non-response rate. Thus far, there is no specific biomarker to predict the response to CRT in patients with heart failure. In this study, we assessed the role of the blood metabolomic profile in predicting the response to CRT.MethodsA total of 105 dilated cardiomyopathy patients with severe heart failure who received CRT were included in our two-stage study. Baseline blood samples were collected prior to CRT implantation. The response to CRT was defined according to echocardiographic criteria. Metabolomic profiling of serum samples was carried out using ultrahigh performance liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry.ResultsSeventeen metabolites showed significant differences in their levels between responders and non-responders, and these metabolites were primarily involved in six pathways, including linoleic acid metabolism, Valine, leucine and isoleucine biosynthesis, phenylalanine metabolism, citrate cycle, tryptophan metabolism, and sphingolipid metabolism. A combination of isoleucine, tryptophan, and linoleic acid was identified as an ideal metabolite panel to distinguish responders from non-responders in the discovery set (n= 51 with an AUC of 0.981), and it was confirmed in the validation set (n= 54 with an AUC of 0.929).ConclusionsMass spectrometry based serum metabolomics approach provided larger coverage of metabolome which can help distinguish CRT responders from non-responders. A combination of isoleucine, tryptophan, and linoleic acid may associate with significant prognostic values for CRT.