Marzoog Basheer Abdullah, Kopylov Philipp
World-Class Research Center (Digital Biodesign and Personalized Healthcare), I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya Street, 119991 Moscow, Russia.
World J Cardiol. 2025 Apr 26;17(4):106593. doi: 10.4330/wjc.v17.i4.106593.
Integrating exhaled breath analysis into the diagnosis of cardiovascular diseases holds significant promise as a valuable tool for future clinical use, particularly for ischemic heart disease (IHD). However, current research on the volatilome (exhaled breath composition) in heart disease remains underexplored and lacks sufficient evidence to confirm its clinical validity. Key challenges hindering the application of breath analysis in diagnosing IHD include the scarcity of studies (only three published papers to date), substantial methodological bias in two of these studies, and the absence of standardized protocols for clinical implementation. Additionally, inconsistencies in methodologies-such as sample collection, analytical techniques, machine learning (ML) approaches, and result interpretation-vary widely across studies, further complicating their reproducibility and comparability. To address these gaps, there is an urgent need to establish unified guidelines that define best practices for breath sample collection, data analysis, ML integration, and biomarker annotation. Until these challenges are systematically resolved, the widespread adoption of exhaled breath analysis as a reliable diagnostic tool for IHD remains a distant goal rather than an imminent reality.
将呼出气分析纳入心血管疾病的诊断，作为未来临床应用的一种有价值工具，尤其是对缺血性心脏病（IHD）而言，具有重大前景。然而，目前关于心脏病挥发组（呼出气成分）的研究仍未得到充分探索，且缺乏足够证据来证实其临床有效性。阻碍呼出气分析应用于IHD诊断的关键挑战包括研究稀缺（迄今为止仅有三篇已发表论文）、其中两项研究存在实质性方法偏差，以及缺乏临床实施的标准化方案。此外，各研究在方法上存在不一致性，如样本采集、分析技术、机器学习（ML）方法和结果解释等方面差异很大，这进一步使其可重复性和可比性变得复杂。为弥补这些差距，迫切需要建立统一指南，以定义呼出气样本采集、数据分析、ML整合和生物标志物注释的最佳实践。在这些挑战得到系统解决之前，将呼出气分析广泛用作IHD的可靠诊断工具仍是一个遥远的目标，而非迫在眉睫的现实。
