Author + information
- Jonathan Neekon Hourmozdi,
- David D. Ralph,
- Stephanie J. Nolley,
- Sam Rayner,
- Sina A. Gharib and
- Peter Leary
Disease-specific metabolomic signatures have been associated with mortality in pulmonary arterial hypertension (PAH). We explore whether this reflects right ventricular (RV) dysfunction.
We analyzed quantitative targeted profiling of over 300 metabolites from a prospective cohort of PAH patients. Cox regression was used to identify baseline echocardiographic and right heart catheterization features associated with mortality. Linear regression was performed to identify metabolites correlated with RV dilation. Partial least squares discriminant analysis (PLS-DA) was used to assess the performance of metabolite variability in predicting RV size and mortality.
Of the 70 patients studied, 13 died over 27–36 months of follow up. After correction for multiple comparisons, only tricuspid annular plane systolic excursion (FDR = 0.04) and RV basal diameter (FDR = 0.02) were associated with mortality. Five unique metabolites were significantly correlated with RV basal diameter (FDR < 0.05). A three component PLS-DA model performed best in cross validation (R2 = 0.73, Q2 = 0.14) with significant class separation (Figure) by 2000-fold permutation (P = 0.03). Separation based on metabolic profiles was greatest between patients with dilated RV who died versus survivors with normal RV size.
Alterations in plasma metabolites are associated with RV dysfunction and prognosis in PAH and may provide insight into the mechanisms driving disease progression.
Sunday, March 29, 2020, 8:25 a.m.-8:35 a.m.
Session Title: Highlighted Original Research: Pulmonary Hypertension and the Year in Review
Abstract Category: 35. Pulmonary Hypertension
Presentation Number: 904-06
- 2020 American College of Cardiology Foundation