There is intense interest in the identification of novel biomarkers which improve the diagnosis of heart failure. Serum samples
from 52 patients with systolic heart failure (EF < 40% plus signs and symptoms of failure) and 57 controls were analyzed by
gas chromatography – time of flight – mass spectrometry and the raw data reduced to 272 statistically robust metabolite peaks.
38 peaks showed a significant difference between case and control (
p < 5 × 10
−5). Two such metabolites were pseudouridine, a modified nucleotide present in t- and rRNA and a marker of cell turnover, as
well as the tricarboxylic acid cycle intermediate 2-oxoglutarate. Furthermore, 3 further new compounds were also excellent
discriminators between patients and controls: 2-hydroxy, 2-methylpropanoic acid, erythritol and 2,4,6-trihydroxypyrimidine.
Although renal disease may be associated with heart failure, and metabolites associated with renal disease and other markers
were also elevated (e.g. urea, creatinine and uric acid), there was no correlation within the patient group between these
metabolites and our heart failure biomarkers, indicating that these were indeed biomarkers of heart failure and not renal
disease
per se. These findings demonstrate the power of data-driven metabolomics approaches to identify such markers of disease.
Keywords heart failure - metabolomics - biomarkers - pseudouridine - 2-oxoglutarate
Warwick B. Dunn, David I. Broadhurst and Sasalu M. Deepak contributed equally to this work.