EXHALED ACETONE AS A NEW BIOMARKER OF HEART FAILURE SEVERITY.
Chest. 2012 Feb 16;
Authors: Marcondes-Braga FG, Gutz IG, Batista GL, Saldiva PH, Ayub-Ferreira SM, Issa VS, Mangini S, Bocchi EA, Bacal F
Abstract: BACKGROUND:Heart failure (HF) is associated with poor prognosis and the identification of biomarkers of its severity could help in its treatment. In a pilot study, we observed high levels of acetone in exhaled breath of HF patients. The present study was designed to evaluate exhaled acetone as a biomarker of HF diagnosis and HF severity. METHODS:From 235 patients with systolic dysfunction evaluated between May/2009 and September/2010, 89 patients (HF group) fulfilled inclusion criteria and were compared to sex- and age-matched healthy subjects (control group, n=20). HF patients were grouped according to clinical stability in acute decompensated HF (ADHF, n=59) and chronic HF (ChronHF,n=30) groups and submitted to exhaled breath collection. Identification of chemical species was done by gas chromatography-mass spectrometry and quantification by spectrophotometry. Diabetics were excluded. RESULTS:The median (interquartile range) concentration of exhaled breath acetone (EBA) was higher in HF group when compared to control group [3.7?g/l (1.69-10.45) vs 0.39?g/l (0.30-0.79), p<0.001] and also higher in ADHF group when compared to ChronHF group [7.8?g/l (3.6-15.2) vs 1.22?g/l (0.68-2.19), p<0.001]. The accuracy and sensitivity of this method to diagnose HF and ADHF were around 85%, a value similar to that obtained with B-type natriuretic peptide (BNP). EBA levels differed significantly as a function of severity of HF (NYHA classification,p<0.001). There was a positive correlation between EBA and BNP (r=0.772, p<0.001). CONCLUSIONS:EBA is not only a promising non-invasive diagnostic method of HF, whose accuracy is equivalent to BNP, but also a new biomarker of HF severity.
PMID: 22345382 [PubMed - as supplied by publisher]