title: Metabolomic profile of human myocardial ischemia by nuclear magnetic resonance spectroscopy of peripheral blood serum: a translational study based on transient coronary occlusion models.
abstract: OBJECTIVE
  The aim of this study was to investigate the metabolomic profile of acute myocardial ischemia (MIS) using nuclear magnetic resonance spectroscopy of peripheral blood serum of swine and patients undergoing angioplasty balloon-induced transient coronary occlusion.
  
  
  BACKGROUND
  Biochemical detection of MIS is a major challenge. The validation of novel biosignatures is of utmost importance.
  
  
  METHODS
  High-resolution nuclear magnetic resonance spectroscopy was used to profile 32 blood serum metabolites obtained (before and after controlled ischemia) from swine (n = 9) and patients (n = 20) undergoing transitory MIS in the setting of planned coronary angioplasty. Additionally, blood serum of control patients (n = 10) was sequentially profiled. Preliminary clinical validation of the developed metabolomic biosignature was undertaken in patients with spontaneous acute chest pain (n = 30).
  
  
  RESULTS
  Striking differences were detected in the blood profiles of swine and patients immediately after MIS. MIS induced early increases (10 min) of circulating glucose, lactate, glutamine, glycine, glycerol, phenylalanine, tyrosine, and phosphoethanolamine; decreases in choline-containing compounds and triacylglycerols; and a change in the pattern of total, esterified, and nonesterified fatty acids. Creatine increased 2 h after ischemia. Using multivariate analyses, a biosignature was developed that accurately detected patients with MIS both in the setting of angioplasty-related MIS (area under the curve 0.94) and in patients with acute chest pain (negative predictive value 95%).
  
  
  CONCLUSIONS
  This study reports, to the authors' knowledge, the first metabolic biosignature of acute MIS developed under highly controlled coronary flow restriction. Metabolic profiling of blood plasma appears to be a promising approach for the early detection of MIS in patients.
authors.affiliation: Cardiology Department, Hospital Clinico Universitario-INCLIVA, Universidad de Valencia, Valencia, Spain. vicentbodi@hotmail.com
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodi
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: Jose M
authors.initials: JM
authors.lastname: Morales
authors.forename: Vannina G
authors.initials: VG
authors.lastname: Marrachelli
authors.forename: Julio
authors.initials: J
authors.lastname: Nunez
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Forteza
authors.forename: Fabian
authors.initials: F
authors.lastname: Chaustre
authors.forename: Cristina
authors.initials: C
authors.lastname: Gomez
authors.forename: Luis
authors.initials: L
authors.lastname: Mainar
authors.forename: Gema
authors.initials: G
authors.lastname: Minana
authors.forename: Eva
authors.initials: E
authors.lastname: Rumiz
authors.forename: Oliver
authors.initials: O
authors.lastname: Husser
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Noguera
authors.forename: Ana
authors.initials: A
authors.lastname: Diaz
authors.forename: David
authors.initials: D
authors.lastname: Moratal
authors.forename: Arturo
authors.initials: A
authors.lastname: Carratala
authors.forename: Xavier
authors.initials: X
authors.lastname: Bosch
authors.forename: Angel
authors.initials: A
authors.lastname: Llacer
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Juan R
authors.initials: JR
authors.lastname: Viña
authors.forename: Daniel
authors.initials: D
authors.lastname: Monleon
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D015415:Biomarkers / Q000032:analysis / Q000097:blood*; D054059:Coronary Occlusion / Q000097:blood / Q000175:diagnosis; D003937:Diagnosis, Differential; D004195:Disease Models, Animal; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis; D009206:Myocardium / Q000378:metabolism*; D015203:Reproducibility of Results; D013552:Swine
chemical_list: D015415:Biomarkers