title: 1H-NMR-based metabolic analysis of human serum reveals novel markers of myocardial energy expenditure in heart failure patients.
abstract: OBJECTIVE
  Elevated myocardial energy expenditure (MEE) is related with reduced left ventricular ejection fraction, and has also been documented as an independent predictor of cardiovascular mortality. However, the serum small-molecule metabolite profiles and pathophysiological mechanisms of elevated MEE in heart failure (HF) are still lacking. Herein, we used 1H-NMR-based metabolomics analysis to screen for potential biomarkers of MEE in HF.
  
  
  METHODS
  A total of 61 subjects were enrolled, including 46 patients with heart failure and 15 age-matched controls. Venous serum samples were collected from subjects after an 8-hour fast. An INOVA 600 MHz nuclear magnetic resonance spectrometer with Carr-Purcell-Melboom-Gill (CPMG) pulse sequence was employed for the metabolomics analysis and MEE was calculated using colored Doppler echocardiography. Metabolomics data were processed using orthogonal signal correction and regression analysis was performed using the partial least squares method.
  
  
  RESULTS
  The mean MEE levels of HF patients and controls were 139.61±58.18 cal/min and 61.09±23.54 cal/min, respectively. Serum metabolomics varied with MEE changed, and 3-hydroxybutyrate, acetone and succinate were significantly elevated with the increasing MEE. Importantly, these three metabolites were independent of administration of angiotensin converting enzyme inhibitor, β-receptor blockers, diuretics and statins (P>0.05).
  
  
  CONCLUSIONS
  These results suggested that in patients with heart failure, MEE elevation was associated with significant changes in serum metabolomics profiles, especially the concentration of 3-hydroxybutyrate, acetone and succinate. These compounds could be used as potential serum biomarkers to study myocardial energy mechanism in HF patients.
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China.
authors: Zhiyong
authors: Z
authors: Du
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Department of Cardiology, The Third Hospital of Southern Medical University, Guangzhou, China.
authors: Anna
authors: A
authors: Shen
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors: Yuli
authors: Y
authors: Huang
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China.
authors: Liang
authors: L
authors: Su
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China.
authors: Wenyan
authors: W
authors: Lai
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China.
authors: Peng
authors: P
authors: Wang
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China.
authors: Zhibing
authors: Z
authors: Xie
authors: Department of Cardiology, Guangzhou General Hospital of PLA, Guangzhou, China.
authors: Zhiquan
authors: Z
authors: Xie
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China.
authors: Qingchun
authors: Q
authors: Zeng
authors: Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China ; Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors: Hao
authors: H
authors: Ren
authors: Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China ; Key Laboratory For Organ Failure Research, Ministry of Education of the People's Republic of China, Guangzhou, China.
authors: Dingli
authors: D
authors: Xu
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood / Q000378:metabolism; D000096:Acetone / Q000097:blood / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004734:Energy Metabolism; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D008297:Male; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D019906:Nuclear Magnetic Resonance, Biomolecular / Q000379:methods*; D044967:Serum / Q000378:metabolism; D019802:Succinic Acid / Q000097:blood / Q000378:metabolism
chemical_list: D000096:Acetone; D019802:Succinic Acid; D020155:3-Hydroxybutyric Acid