Exhaled Acetone Concentration Is Related to Hemodynamic Severity in Patients With Non-Ischemic Chronic Heart Failure

• Yokokawa Tetsuro

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Sugano Yasuo

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Shimouchi Akito

  Department of Cardiac Physiology, National Cerebral and Cardiovascular Center

• Shibata Atsushi

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Jinno Naoya

  Department of Cardiac Physiology, National Cerebral and Cardiovascular Center

• Nagai Toshiyuki

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Kanzaki Hideaki

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Aiba Takeshi

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Kusano Kengo

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Shirai Mikiyasu

  Department of Cardiac Physiology, National Cerebral and Cardiovascular Center

• Takeishi Yasuchika

  Department of Cardiology and Hematology, Fukushima Medical University

• Yasuda Satoshi

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Ogawa Hisao

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Anzai Toshihisa

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

抄録

Background:We hypothesized that exhaled acetone concentration (EAC), reflecting altered blood ketone body metabolism and increased acetone exhaust because of pulmonary congestion in heart failure (HF), would correlate with hemodynamic parameters in patients with non-ischemic chronic HF.Methods and Results:We prospectively enrolled 102 non-ischemic HF patients with New York Heart Association (NYHA) class I–III. Exhaled breath was collected after an overnight fast. Echocardiography and cardiac catheterization were performed in all patients. We also enrolled 17 control patients without HF. EAC in the HF patients was significantly higher than that in the control patients (median EAC; 0.53 vs. 0.38 ppm, P=0.012). EAC positively correlated with blood total ketone bodies (r=0.454, P<0.001), NYHA class (r=0.489, P<0.001), and plasma B-type natriuretic peptide (r=0.316, P=0.001). Right heart catheterization revealed that EAC significantly correlated with pulmonary capillary wedge pressure (PCWP, r=0.377, P<0.001). Receiver-operating characteristic analysis revealed that EAC >1.05 ppm was associated with PCWP ≥18 mmHg (area under the curve [AUC] 0.726, sensitivity 50%, specificity 89%). EAC was shown to be a comparable diagnostic biomarker for HF to BNP (AUC 0.760, sensitivity 80%, specificity 70%).Conclusions:EAC may be a novel noninvasive biomarker that correlates hemodynamic severity in non-ischemic chronic HF. (Circ J 2016; 80: 1178–1186)

収録刊行物

• Circulation Journal

  Circulation Journal 80 (5), 1178-1186, 2016

  一般社団法人 日本循環器学会

キーワード

• Biomarker
• Breath analysis
• Exhaled acetone concentration
• Heart failure
• Hemodynamics

詳細情報

• CRID: 1390001205107241856
• NII論文ID: 130005147652
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-16-0011
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 027269981
• PubMed: 27026173
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I027269981
• Web Site: https://www.jstage.jst.go.jp/article/circj/80/5/80_CJ-16-0011/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2017010408
• 本文言語コード: en
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