title: Metabolomic approach to profile functional and metabolic changes in heart failure.
abstract: BACKGROUND
  Heart failure (HF) is characterized by a series of adaptive changes in energy metabolism. The use of metabolomics enables the parallel assessment of a wide range of metabolites. In this study, we appraised whether metabolic changes correlate with HF severity, assessed as an impairment of functional contractility, and attempted to interpret the role of metabolic changes in determining systolic dysfunction.
  
  
  METHODS
  A 500 MHz proton nuclear magnetic resonance ((1)H-NMR)-based analysis was performed on blood samples from three groups of individuals: 9 control subjects (Group A), 9 HF patients with mild to moderate impairment of left ventricle ejection fraction (LVEF: 41.9 ± 4.0 %; Group B), and 15 HF patients with severe LVEF impairment (25.3 ± 10.3 %; Group C). In order to create a descriptive model of HF, a supervised orthogonal projection on latent structures discriminant analysis (OPLS-DA) was applied using speckle tracking-derived longitudinal strain rate as the Y-variable in the multivariate analysis.
  
  
  RESULTS
  OPLS-DA identified three metabolic clusters related to the studied groups achieving good values for R(2) [R(2)(X) = 0.64; R(2)(Y) = 0.59] and Q(2) (0.39). The most important metabolites implicated in the clustering were 2-hydroxybutyrate, glycine, methylmalonate, and myo-inositol.
  
  
  CONCLUSIONS
  The results demonstrate the suitability of metabolomics in combination with functional evaluation techniques in HF staging. This innovative tool should facilitate investigation of perturbed metabolic pathways in HF and their correlation with the impairment of myocardial function.
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Asse didattico Medicina, SS Sestu KM 0.700, 09042, Monserrato, Italy. martino.deidda@tiscali.it.
authors.forename: Martino
authors.initials: M
authors.lastname: Deidda
authors.affiliation: Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy. cristina.piras@unica.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Piras
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Asse didattico Medicina, SS Sestu KM 0.700, 09042, Monserrato, Italy. cadedduc@unica.it.
authors.forename: Christian Cadeddu
authors.initials: CC
authors.lastname: Dessalvi
authors.affiliation: Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy. elocci@unica.it.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Locci
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Monserrato, Italy. barberini@unica.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Barberini
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Asse didattico Medicina, SS Sestu KM 0.700, 09042, Monserrato, Italy. torrifederica28@gmail.com.
authors.forename: Federica
authors.initials: F
authors.lastname: Torri
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Asse didattico Medicina, SS Sestu KM 0.700, 09042, Monserrato, Italy. federicaascedu85@hotmail.it.
authors.forename: Federica
authors.initials: F
authors.lastname: Ascedu
authors.affiliation: Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy. latzori@unica.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Atzori
authors.affiliation: Department of Medical Sciences "M. Aresu", University of Cagliari, Asse didattico Medicina, SS Sestu KM 0.700, 09042, Monserrato, Italy. giuseppemercuro@gmail.com.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mercuro
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008297:Male; D055432:Metabolomics; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D066244:Proton Magnetic Resonance Spectroscopy
chemical_list: D020097:Natriuretic Peptide, Brain