Metabolomic does not predict response to cardiac   resynchronization therapy in patients with heart failure.
OBJECTIVE
Metabolomic, a systematic study of metabolites, may be a useful tool in understanding the pathological processes that underlie the occurrence and progression of a disease. We hypothesized that metabolomic would be helpful in assessing a specific pattern in heart failure patients, also according to the underlining causes and in defining, prior to device implantation, the responder and nonresponder patient to cardiac resynchronization therapy (CRT).


METHODS
In this prospective study, blood and urine samples were collected from 32 heart failure patients who underwent CRT. Clinical, electrocardiography and echocardiographic evaluation was performed in each patient before CRT and after 6 months of follow-up. Thirty-nine age and sex-matched healthy individuals were chosen as control group. For each sample, 1H-NMR spectra, Nuclear Overhauser Enhancement Spectroscopy, Carr-Purcell-Meiboom-Gill and diffusion edited spectra were measured.


RESULTS
A different metabolomic fingerprint was demonstrated in heart failure patients compared to healthy controls with high accuracy level. Metabolomics fingerprint was similar between patients with ischemic and nonischemic dilated cardiomyopathy. At 6-month follow-up, metabolomic fingerprint was different from baseline. At follow-up, heart failure patients’ metabolomic fingerprint remained significantly different from that of healthy controls, and accuracy of cause discrimination remained low. Responders and nonresponders had a similar metabolic fingerprint at baseline and after 6 months of CRT.


CONCLUSIONS
It is possible to identify a metabolomic fingerprint characterizing heart failure patients candidate to CRT, it is independent of the different causes of the disease and it is not predictive of the response to CRT.
Luigi
L
Padeletti
Pietro A
PA
Modesti
Stella
S
Cartei
Luca
L
Checchi
Giuseppe
G
Ricciardi
Paolo
P
Pieragnolia
Stefania
S
Sacchi
Margherita
M
Padeletti
Brunetto
B
Alterini
Pietro
P
Pantaleo
Xiaoyu
X
Hu
Leonardo
L
Tenori
Claudio
C
Luchinat
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood / Q000652:urine; D058406:Cardiac Resynchronization Therapy; D002311:Cardiomyopathy, Dilated / Q000378:metabolism / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000378:metabolism / Q000628:therapy*; D006801:Humans; D008297:Male; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
D015415:Biomarkers