Metabolomics-Based Assessment of Short-Term Metabolic Disturbance after Acute Heart Failure, and in Response to Nutritional Supplements

Heart failure (HF) is a complex clinical syndrome that represents the end stage of various cardiac diseases. The estimated cost of HF is currently between 1–2% of the total healthcare spend in developed economies and is expected to rise. Nevertheless, short- and long-term HF-related re-hospitalization and mortality remain high. Recent advances in molecular techniques, computing power, and bio-informatics have enabled efficient metabolite profiling on a larger scale, called metabolomics. Nutritional intervention has recently been considered to be a new therapeutic target for HF. However, mechanistical metabolite-guided measure is currently not available to sensitively evaluate the status of molecule-level malnutrition. Accordingly, the platform of metabolomics-based assessment may provide sensitive and direct information linking to the changes in metabolites after acute events. Our previous study identified the HF-associated metabolic perturbation. Based on the findings, we develop metabolomics-based diagnostic and prognostic panels to evaluate metabolic disturbance in patients with acute HF, which was published in “The Journal of American College of Cardiology, 2015”. The metabolic abnormalities are totally different from those with malnutrition due to other etiologies (The detailed metabolites and calculation models are shown in this proposal). However, the period of “subacute stage” is the best timing for metabolic assessment and personalized nutritional intervention after acute HF. So far, no available information can be referred at this subacute stage regarding the short-term metabolic changes in a serial of time points. Meanwhile, there is no scientific way to estimate the effect of nutritional support by commercially available nutritional supplements. Given that the timing and personalized strategy of nutritional support is important, however, not available at present time, the main themes of this study contain 2 aims: Aim #1: To measure metabolites serially for patients after acute HF, so that we can realize the speed of changes in HF-related metabolites after acute HF, and try to interpret the findings. All the metabolomics panels created in our previous publications for both diagnosis and prognosis will be used in this study. Aim #2: To test whether commercially available nutritional support improves the metabolomics-based metabolic parameters. Since the impact of these nutritional supports on patients with HF has not been investigated, all the metabolomics panels created in our previous publications for both diagnosis and prognosis will also be used in this study for subtle estimation, provided these patients have substantial mitochondrial dysfunction in utilizing lipid as an energy source

Project ID:PC10601-0859
External Project ID:MOST105-2314-B182-046-MY2