Breath Markers of Oxidative Stress in Patients with Unstable Angina

Abstract

Cardiac chest pain is accompanied by oxidative stress, which generates alkanes and other volatile organic compounds (VOCs). These VOCs are excreted in the breath and could potentially provide a rational diagnostic marker of disease. The breath methylated alkane contour (BMAC), a 3-dimensional surface plot of C4-C20 alkanes and monomethylated alkanes, provides a comprehensive set of markers of oxidative stress. In this pilot study, we compared BMACs in patients with unstable angina pectoris and in healthy volunteers. Breath VOCs were analyzed in 30 patients with unstable angina confirmed by coronary angiography and in 38 age-matched healthy volunteers with no known history of heart disease (mean age +/- SD, 62.7 +/- 12.3 years and 62.5 +/- 10.0, not significant). BMACs in both groups were compared to identify the combination of VOCs that provided the best discrimination between the 2 groups. Forward stepwise entry discriminant analysis selected 8 VOCs to construct a predictive model that correctly classified unstable angina patients with sensitivity of 90% (27 of 30) and specificity of 73.7% (28 of 38). On cross-validation, sensitivity was 83.3% (25 of 30) and specificity was 71.1% (27 of 38). We conclude that the breath test distinguished between patients with unstable angina and healthy control subjects.

Volatile compounds characteristic of sinus-related bacteria and infected sinus mucus: Analysis by solid-phase microextraction and gas chromatography–mass spectrometry

“…A number of investigations have focused on human breath analysis for volatile compounds indicative of oral [19][20][21] and systemic [18,[22][23][24][25][26][27][28][29][30][31] pathologies. Exhaled air may be collected in a relatively non-invasive manner, with minimal inconvenience for the patient [32][33][34].…”

Assessment of the exhalation kinetics of volatile cancer biomarkers based on their physicochemical properties

“…• 5-Methyl-tridecane (CAS 25117-31-1) has been suggested to be a volatile biomarker of breast cancer [111] and belongs to the class of monomethylated hydrocarbons, which were proposed to be used in the 'breath methylated alkane contour' (BMAC) for detection of cancer and other diseases [124][125][126][127][128][129][130].…”

Breathomics as a diagnostic tool for pulmonary embolism

“…As a minority of these latter patients will have PE, an increase in the number of patients in whom PE can be excluded without additional imaging is mandatory. The eNose is an interesting diagnostic tool in patients with suspected PE, especially in those without comorbidity [8][9][10][11].…”