‘Breathprint’ offers efficient diagnosis of heart failure
medwireNews: Analysis of a single exhaled breath of air or "breathprint" can be used to quickly diagnose patients with heart failure, shows research.
"Our findings demonstrate the feasibility of single exhaled breath analysis in acute decompensated heart failure (ADHF)… and provided pilot evidence to support the hypothesis that a unique ADHF breathprint exists" say Raed Dweik (The Cleveland Clinic, Ohio, USA) and colleagues.
In a single-center, prospective study, the researchers used selected ion-flow tube mass-spectrometry (SIFT-MS) to scan the exhaled breath of 25 patients within 24 hours of their admission to hospital with ADHF as their primary diagnosis. They also scanned the breath of 16 control individuals admitted with non-ADHF cardiovascular diagnoses including unstable angina or non-ST-segment elevation myocardial infarction, stable angina, conduction disorders, hypertensive emergency, and atrial tachyarrhythmia.
As reported in the Journal of the American College of Cardiology, the team identified significantly increased levels of the volatile organic compounds (VOCs) acetone and pentane in the patients with ADHF, compared with the controls, at 811 parts per billion (ppb) versus 187 ppb, and 40 ppb versus 22 ppb, respectively.
In addition, the researchers performed mass scanning of ion products for H3O+, O2+, and NO+ from 14 to 200 atomic mass units. This process identified five ion peaks that were used in a discrimination model that could successfully distinguish ADHF patients from controls.
Furthermore, this "breathprint" was validated in a cohort of 36 individuals with ADHF and identical enrolment criteria to the original ADHF cohort.
Dweik et al say that current methods for identifying individuals with decompensation are unreliable and time consuming. The SIFT-MS technique on the other hand, "combines a fast flow tube technique with quantitative mass spectrometry that is ideally suited to exhaled breath analysis because it allows for the analysis of small and humid samples without the need for cumbersome sample preparation or calibration," they explain.
In addition, if a specific VOC or a panel of VOCs that can diagnose ADHF can be identified, then highly sensitive and specific sensors could be integrated into portable detectors and used to aid point-of-care ambulatory monitoring and screening, note the researchers.
"Further studies in exhaled breath metabolomics are needed to accelerate progress in the field of cardiovascular medicine," concludes the team.
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By Sally Robertson, medwireNews Reporter