Unit of Geriatrics, Campus Bio-Medico University, via Alvaro del Portillo 200, I-00128 Rome, Italy.
J Breath Res. 2018 Feb 6;12(2):026007. doi: 10.1088/1752-7163/aa8cd4.
Analysis of exhaled volatile organic compounds (VOCs) may be applied for diagnostic purposes in some chronic diseases, but there are no data on their role for discriminating people with congestive heart failure (CHF), particularly in older patients where natriuretic peptides have lower accuracy. We evaluated whether VOCs analysis can discriminate patients with or without CHF, stratify CHF severity and predict the response to therapy of decompensated CHF.
We recruited 89 subjects admitted to an acute care ward with acutely decompensated CHF, 117 healthy controls and 103 chronic obstructive pulmonary disease (COPD) controls. CHF patients performed echocardiography. VOCs were collected using the Pneumopipe and analyzed with the BIONOTE electronic nose. Partial least square analysis was used to evaluate the discriminative capacity of VOCs. Accuracy in discrimination of CHF versus healthy and COPD controls was 81% and 69%, respectively; accuracy did not decrease in a sensitivity analysis excluding subjects younger than 65 and older than 80 years. In CHF patients VOCs pattern could predict with fair precision ejection fraction and systolic pulmonary arterial pressure, but not changes in weight due to therapy.
VOCs pattern is able to discriminate older CHF patients from healthy people and COPD patients and correlates with cardiac function markers.
分析呼出的挥发性有机化合物（VOCs）可用于某些慢性疾病的诊断目的，但尚无关于其在区分充血性心力衰竭（CHF）患者中的作用的数据，特别是在利钠肽准确性较低的老年患者中。我们评估了 VOCs 分析是否可以区分有或没有 CHF 的患者，对 CHF 严重程度进行分层，并预测失代偿性 CHF 治疗的反应。
我们招募了 89 名因急性失代偿性 CHF 入住急性护理病房的患者、117 名健康对照者和 103 名慢性阻塞性肺疾病（COPD）对照者。CHF 患者进行了超声心动图检查。使用 Pneumopipe 采集 VOCs 并使用 BIONOTE 电子鼻进行分析。偏最小二乘分析用于评估 VOCs 的区分能力。CHF 与健康和 COPD 对照组的区分准确率分别为 81%和 69%；在排除年龄小于 65 岁和大于 80 岁的患者的敏感性分析中，准确率并未降低。在 CHF 患者中，VOCs 模式可以以相当的精度预测射血分数和收缩性肺动脉压，但不能预测因治疗而导致的体重变化。
VOCs 模式能够区分老年 CHF 患者与健康人群和 COPD 患者，并与心脏功能标志物相关。
