Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF). One Year of Clinical Follow-up.

Autor:	Marcondes-Braga FG; Department of Heart Transplant, Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil Av. Dr Eneas de Carvalho Aguiar, 44 - 2°. andar., Batista GL; Chemistry Institute, University of São Paulo, Sao Paulo, Brazil Av.Prof. Lineu Prestes, 748, bloco 12, sala 1270-Cidade Universitária., Gutz IG; Chemistry Institute, University of São Paulo, Sao Paulo, Brazil Av.Prof. Lineu Prestes, 748, bloco 12, sala 1270-Cidade Universitária., Saldiva PH; Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil Av. Dr. Arnaldo, 455, 1° andar., Mangini S; Department of Heart Transplant, Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil Av. Dr Eneas de Carvalho Aguiar, 44 - 2°. andar., Issa VS; Department of Heart Failure, Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil., Ayub-Ferreira SM; Department of Heart Failure, Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil., Bocchi EA; Department of Heart Failure, Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil., Pereira AC; Laboratory of Genetics and Molecular Cardiology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil Av.Dr. Eneas de Carvalho Aguiar, 44-10°. andar., Bacal F; Department of Heart Transplant, Heart Institute (InCor), do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil Av. Dr Eneas de Carvalho Aguiar, 44 - 2°. andar.
Jazyk:	angličtina
Zdroj:	PloS one [PLoS One] 2016 Dec 28; Vol. 11 (12), pp. e0168790. Date of Electronic Publication: 2016 Dec 28 (Print Publication: 2016).
DOI:	10.1371/journal.pone.0168790
Abstrakt:	Background: The identification of new biomarkers of heart failure (HF) could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA) is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis. Objectives: To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF). Methods: After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year. Study physicians, blind to the results of cardiac biomarker testing, ascertained vital status of each study participant at 12 months. Results: The composite endpoint death and heart transplantation (HT) were observed in 35 patients (39.3%): 29 patients (32.6%) died and 6 (6.7%) were submitted to HT within 12 months after study enrollment. High levels of EBA (≥3.7μg/L, 50th percentile) were associated with a progressively worse prognosis in 12-month follow-up (log-rank = 11.06, p = 0.001). Concentrations of EBA above 3.7μg/L increased the risk of death or HT in 3.26 times (HR = 3.26, 95%CI = 1.56-6.80, p = 0.002) within 12 months. In a multivariable cox regression model, the independent predictors of all-cause mortality were systolic blood pressure, respiratory rate and EBA levels. Conclusions: High EBA levels could be associated to poor prognosis in HFrEF patients. Competing Interests: The authors have declared that no competing interests exist.
Databáze:	MEDLINE
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