Basler Sarah, Fricke Kai, Sievi Noriane A, Arvaji Alexandra, Schmidt Felix, Herth Jonas, Baur Diego M, Kohler Malcolm, Ulrich Silvia, Lichtblau Mona
Department of Pulmonology, University Hospital Zurich, Raemistrasse 100, Zurich 8091, Switzerland.
Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, Zurich 8032, Switzerland.
Eur Heart J Open. 2025 May 23;5(3):oeaf060. doi: 10.1093/ehjopen/oeaf060. eCollection 2025 May.
The aim of this initial study was to explore whether prediction models based on breath metabolome profiles could detect differences between pulmonary vascular disease (PVD) patients and healthy controls. Additionally, we sought to investigate the potential to distinguish between two major subtypes of PVD-pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH)-to support early detection and targeted treatment.
We used real-time breath analysis to compare the breath profiles of patients with PVD to healthy controls, and the metabolome of patients with PAH to those with CTEPH. Pathway enrichment analysis was conducted to reveal underlying metabolic pathways. Breath profiles of 75 patients (47 (62.7%) with PAH and 28 (37.3%) with CTEPH) were analysed and compared with those of 115 healthy controls. The prediction models identified PVD with an area under the curve of 0.917 and distinguished PAH from CTEPH with an AUC of 0.764. PVD patients showed significant metabolic alterations, particularly in fatty acid synthesis and fatty acid activation.
Breath analysis shows potential as a non-invasive and real-time diagnostic tool by demonstrating detectable differences in breath profiles between PVD patients and healthy controls. Establishing these differences is a critical first step in assessing the feasibility of identifying breath markers for PVD and exploring further differentiation between PAH and CTEPH.
Trial registration number: NCT05458934.
这项初步研究的目的是探索基于呼吸代谢组图谱的预测模型是否能够检测出肺血管疾病（PVD）患者与健康对照之间的差异。此外，我们试图研究区分PVD的两种主要亚型——肺动脉高压（PAH）和慢性血栓栓塞性肺动脉高压（CTEPH）的可能性，以支持早期检测和靶向治疗。
我们使用实时呼吸分析比较PVD患者与健康对照的呼吸图谱，以及PAH患者与CTEPH患者的代谢组。进行通路富集分析以揭示潜在的代谢途径。分析了75例患者（47例（62.7%）为PAH，28例（37.3%）为CTEPH）的呼吸图谱，并与115例健康对照的图谱进行比较。预测模型识别PVD的曲线下面积为0.917，区分PAH与CTEPH的曲线下面积为0.764。PVD患者表现出显著的代谢改变，尤其是在脂肪酸合成和脂肪酸活化方面。
呼吸分析通过证明PVD患者与健康对照在呼吸图谱上存在可检测到的差异，显示出作为一种非侵入性实时诊断工具的潜力。确定这些差异是评估识别PVD呼吸标志物的可行性以及探索PAH与CTEPH进一步区分的关键第一步。
试验注册号：NCT05458934。
