Exhaled Breath Analysis in Heart Failure

Marcondes‐Braga, Fabiana G.; Batista, Guilherme Lopes; Bacal, Fernando; Gutz, Ivano Gebhardt Rolf

doi:10.1007/s11897-016-0294-8

Cited by 34 publications

(20 citation statements)

References 35 publications

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“…Arterial ketone body ratio, which reflects hepatic mitochondrial oxidation-reduction potential, is independently associated with cardiac death in patients with acute heart failure [21]. Breath acetone level, which reflects blood ketone bodies, has been reported to be a prognostic factor in heart failure patients with reduced ejection fraction [22], [23]. In patients with hemodialysis, circulating ketone bodies predict cardiovascular events [24].…”

Section: Discussionmentioning

confidence: 99%

Circulating acetoacetate is associated with poor prognosis in heart failure patients

Yokokawa

Yoshihisa

Kanno

et al. 2019

IJC Heart & Vasculature

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BackgroundAcetoacetate is used as an alternative energy source in the heart, and has the potential to improve cardiac function. However, the prognostic impact of acetoacetate has not been investigated in heart failure.MethodsThis study enrolled consecutive 615 hospitalized patients with heart failure. We investigated the associations between circulating acetoacetate and clinical characteristics or prognosis in HF patients.ResultsWe divided the patients into two groups based on circulating acetoacetate levels (high group: acetoacetate ≥35 µmoL/L, n = 313; and low group: acetoacetate <35 µmoL/L, n = 302). The high group had an older age (68 vs. 65 years, P = 0.003) and higher log brain natriuretic peptide levels (2.43 vs. 2.23, P < 0.001) compared with the low group. In contrast, there were no significant differences in the prevalence of co-morbidities, including diabetes mellitus, chronic kidney disease, and anemia, between the two groups. During the median follow-up period of 328 days, 66 all-cause deaths occurred. The high group had a worse prognosis compared with the low group (Log rank, P = 0.041). In the Cox proportional hazard analysis, circulating acetoacetate levels (per 10 µmoL/L increase) were associated with all-cause mortality (hazard ratio 1.020, 95% confidence interval 1.010–1.030, P < 0.001).ConclusionsCirculating acetoacetate is associated with all-cause mortality in patients with heart failure. These results provide new insights into the role of alternative cardiac metabolism in heart failure patients, and raise the possibility of acetoacetate as a novel biomarker to predict the prognosis of heart failure patients.

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Section: Discussionmentioning

confidence: 99%

Circulating acetoacetate is associated with poor prognosis in heart failure patients

Yokokawa

Yoshihisa

Kanno

et al. 2019

IJC Heart & Vasculature

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“…socio-demographic, clinical examination, medical condition, lab tests, medication intake, phenotypic data, sensor data) along with machine learning techniques are presented in [24,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]49]. Recent studies have identified certain biomarkers which strongly correlate with the HF severity, progression and mortality [64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81], while the progress in analytical chemistry and biosensor development allowed their detection in saliva and breath [82][83][84][85] with prominent merits due to the easy and non-invasive sample collection. The Event prediction module aims to inform the experts about the possible presence of adverse events (relapses and mortality): (i) by introducing saliva and breath biomarkers into the adverse event prediction process, (ii) based on a machine le...…”

Section: Event Prediction Modulementioning

confidence: 99%

HEARTEN KMS – A knowledge management system targeting the management of patients with heart failure

Tripoliti

Karanasiou

Kalatzis

et al. 2019

Journal of Biomedical Informatics

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The aim of this work is to present the HEARTEN Knowledge Management System, one of the core modules of the HEARTEN platform. The HEARTEN platform is an mHealth collaborative environment enabling the Heart Failure patients to self-manage the disease and remain adherent, while allowing the other ecosystem actors (healthcare professionals, caregivers, nutritionists, physical activity experts, psychologists) to monitor the patient's health progress and offer personalized, predictive and preventive disease management. The HEARTEN Knowledge Management System is a tool which provides multiple functionalities to the ecosystem actors for the assessment of the patient's condition, the estimation of the patient's adherence, the prediction of potential adverse events, the calculation of Heart Failure related scores, the extraction of statistics, the association of patient clinical and non-clinical data and the provision of alerts and suggestions. The innovation of this tool lays in the analysis of multiparametric personal data coming from different sources, including for the first time breath and saliva biomarkers, and the use of machine learning techniques. The HEARTEN Knowledge Management System consists of nine modules. The accuracy of the KMS modules ranges from 78-95% depending on the module/functionality.

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“…Stress resulting from a disturbance in the balance of reactive oxygen species (ROS) and antioxidant defence induces myocyte hypertrophy, cell apoptosis and calcium overload associated with oxidation of membrane phospholipids, proteins and DNA 4 5. Accurate measurement of oxidative stress in vivo is challenging, but analysis of exhaled breath analysis has emerged as a non-invasive tool, and it has been evaluated in patients with CHF 6. Measurement of exhaled acetone, a volatile component of ketone bodies produced by decarboxylation of acetoacetate, was found to be a useful non-invasive method of evaluating congestive haemodynamics in patients with non-ischaemic CHF 7…”

Section: Introductionmentioning

confidence: 99%

Decrease in exhaled hydrogen as marker of congestive heart failure

Shibata

Sugano²,

Shimouchi

et al. 2018

Open Heart

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ObjectiveHydrogen excretion is thought to be related to systemic antioxidation activity. H2 selectively reduces the hydroxyl radical of free hydrogen (·OH), a highly cytotoxic form of reactive oxygen species, in cultured cells.MethodsWe investigated whether exhaled H2 decreased during night sleep, reflected ·OH production and was associated with heart failure severity. We enrolled 108 patients with chronic heart failure (CHF) and 15 control participants without CHF. H2 concentration was measured by gas chromatography in exhaled breath collected before sleep and in the morning after overnight fasting. Overnight change in H2 concentration (ΔH2) was calculated. Mitochondrial morphology evaluated by transmission electron microscopy in endomyocardial biopsies collected from 18 patients with dilated cardiomyopathy.ResultsΔH2 was significantly lower in patients with CHF compared with controls (−4.3±1.0 vs 2.0±2.1 ppm, p=0.030) and was positively correlated with cardiac index (CI; r = −0.285, p=0.003). Patients with a ΔH2<0 ppm had a significantly lower CI compared with those who had a ΔH2>0 ppm (2.85±0.61 vs 3.24±0.65 L/min/m2, p=0.005). ΔH2 was negatively correlated with both the percentage of vacuole-containing mitochondria and indices of cristae remodelling (r = −0.61, p=0.007).ConclusionsDecrease in exhaled H2 during night sleep was associated with CHF severity. ΔH2 warrants investigation as marker of CHF severity.

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Exhaled Breath Analysis in Heart Failure

Cited by 34 publications

References 35 publications

Circulating acetoacetate is associated with poor prognosis in heart failure patients

Circulating acetoacetate is associated with poor prognosis in heart failure patients

HEARTEN KMS – A knowledge management system targeting the management of patients with heart failure

Decrease in exhaled hydrogen as marker of congestive heart failure

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