Saturday, December 16, 2017

Breath acetone as a biomarker in heart failure: something to follow?


Background: Although breath analysis has emerged as a noninvasive tool in several clinical conditions, it is not widely used in cardiovascular disease yet. Exhaled acetone is one of the compounds expected as biomarkers for heart failure. However, it is unknown how exhaled acetone concentration changes in clinical course of heart failure.

Objective: To investigate time course of exhaled acetone concentration in acute decompensated heart failure.

Methods: This study included 19 patients with acute decompensated heart failure (ADHF group), and 14 stable patients (control group). Exhaled acetone was collected from these patients and the concentration was measured with gas chromatography.

Results: The ADHF group had higher heart rates (p = 0.020), higher levels of brain natriuretic peptide (p less than 0.001), and blood total ketone bodies (p = 0.003), compared with the control group. In ADHF group, exhaled acetone concentration was significantly decreased after treatment (median: 2.40 ppm vs. 0.92 ppm, p less than 0.001). On the other hand, in the control group, exhaled acetone concentration did not significantly change (median: 0.69 ppm vs. 0.62 ppm, p = 0.370, Table 1).

Conclusions: Exhaled acetone concentration in patients with acute decompensated heart failure was drastically decreased by treatment, and therefore, could be a novel noninvasive biomarker to evaluate the course of acute decompensated heart failure.

Ketosis reflects the neurohumeral response in heart failure. Breath acetone as a measure of ketosis is ultrasensitive, non invasive, low tech and with immediate results available at the point of care.

No comments: