title: ¹H nuclear magnetic resonance based metabolic urinary profiling of patients with ischemic heart failure.
abstract: OBJECTIVE
  We sought to identify metabolic pathways characterizing human heart failure (HF) using ¹NMR based urinary metabolomic analysis in conjunction with multivariate statistics.
  
  
  METHODS
  Patients with systolic HF of ischemic origin (n=15) and healthy controls (n=20) participated in this study. Patients with type 2 diabetes mellitus were excluded.
  
  
  RESULTS
  The results showed that the urine of the HF patients had higher levels of metabolites for acetate (p<0.05) and acetone (p<0.01) compared to the healthy controls. In addition, there was a perturbation in methylmalonate metabolism as shown by increased urinary levels of methylmalonic acid (p<0.001) in the HF patients. HF patients also had increased urinary levels of cytosine (p<0.01) and phenylacetylglycine (p<0.01) and decreased 1-methylnicotinamide (p<0.05) compared to healthy controls.
  
  
  CONCLUSIONS
  TCA cycle metabolites and fatty acid metabolism were modified in the HF patients, indicating altered energy metabolism. Moreover, perturbations of metabolism in nucleotide and methylmalonate were observed.
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
authors.forename: Jong-Chul
authors.initials: JC
authors.lastname: Park
authors.forename: Min-Jeong
authors.initials: MJ
authors.lastname: Shin
authors.forename: Hyeran
authors.initials: H
authors.lastname: Lee
authors.forename: Jaewon
authors.initials: J
authors.lastname: Oh
authors.forename: Do Hyun
authors.initials: DH
authors.lastname: Ryu
authors.forename: Geum-Sook
authors.initials: GS
authors.lastname: Hwang
authors.forename: Ji Hyung
authors.initials: JH
authors.lastname: Chung
mesh_terms: D019342:Acetic Acid / Q000652:urine; D000096:Acetone / Q000652:urine; D000368:Aged; D016022:Case-Control Studies; D003596:Cytosine / Q000652:urine; D004734:Energy Metabolism; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives / Q000652:urine; D054143:Heart Failure, Systolic / Q000503:physiopathology / Q000652:urine*; D006801:Humans; D008297:Male; D055442:Metabolome; D055432:Metabolomics; D008764:Methylmalonic Acid / Q000652:urine; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000652:urine*; D009536:Niacinamide / Q000031:analogs & derivatives / Q000652:urine; D019906:Nuclear Magnetic Resonance, Biomolecular; D011522:Protons; D016482:Urinalysis / Q000379:methods*
chemical_list: D011522:Protons; D000096:Acetone; D009536:Niacinamide; C022050:phenylacetylglycine; D003596:Cytosine; D008764:Methylmalonic Acid; D019342:Acetic Acid; D005998:Glycine; C024058:N(1)-methylnicotinamide