ArticleESC heart failure2025
Plasma metabolomics identifies signatures that distinguish heart failure with reduced and preserved ejection fraction.
Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Metabolic Signatures of Atrial Functional Impairment in Paroxysmal Atrial Fibrillation Patients: A CMR Strain-metabolomics Study.Journal of cardiovascular translational research · 2026Article
- Circulating Organic Acid Profiles in Non-Ischaemic Cardiomyopathy: A Case-Control Study.Journal of cardiovascular development and disease · 2026Article
- Differential metabolomic prediction of outcomes in HFpEF and HFrEF: a prospective international multi-ethnic cohort study.Cardiovascular research · 2026Article
- Metrics of left ventricular active relaxation reflect proteomic myocardial remodelling and reverse remodelling.ESC heart failure · 2026Article
- Pre- and post-diagnosis signalling lipid profiles in heart failure with preserved ejection fraction: a prospective cohort study.EBioMedicine · 2026Article
- The Use of Metabolomes in Risk Stratification of Patients with Heart Failure: A Scoping Review.Life (Basel, Switzerland) · 2026Review
- From Single Genes to Systemic Networks: Transcriptomic Insights into Traditional Chinese Medicine for Heart Failure.Drug design, development and therapy · 2026Review
- Dried blood spots capture a wide range of metabolic pathways and biological changes associated with exercise.Metabolomics : Official journal of the Metabolomic Society · 2025Article
- Metabolomic Biomarkers in Heart Failure: A Systematic Review of Diagnostic and Prognostic Significance.Cureus · 2025Review
- Altered Carnitine Metabolism in Ischemic and Non-Ischemic Cardiomyopathy: A Comparative Metabolomics Study Using LC-MS/MS.Metabolites · 2025Article
- A Systemic Perspective of the Link Between Microbiota and Cardiac Health: A Literature Review.Life (Basel, Switzerland) · 2025Review
- Plasma metabolomics identifies signatures that distinguish heart failure with reduced and preserved ejection fraction.ESC heart failure · 2025Article
- Quantitation of BCAA and BCKA in plasma and patient-centric dried blood microsamples in a clinical setting.Bioanalysis · 2025Article
- Obesity and acylcarnitine derivates interplay with coronary artery disease.Scientific reports · 2025Article
- BCAA catabolism targeted therapy for heart failure with preserved ejection fraction.Theranostics · 2025Article
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14 authors.
Funding
Abstract
aimsTwo general phenotypes of heart failure (HF) are recognized: HF with reduced ejection fraction (HFrEF) and with preserved EF (HFpEF). To develop phenotype-specific approaches to treatment, distinguishing biomarkers are needed. The goal of this study was to utilize quantitative metabolomics on a large, diverse population to replicate and extend existing knowledge of the plasma metabolic signatures in human HF.
methodsPlasma metabolomics and proteomics was conducted on 787 samples collected by the Penn Medicine BioBank from subjects with HFrEF (n = 219), HFpEF (n = 357) and matched controls (n = 211). A total of 90 metabolites were analysed, comprising 28 amino acids, 8 organic acids and 54 acylcarnitines. Seven hundred thirty-three of these samples also underwent proteomic profiling via the O-Link proteomics panel.
resultsUnsaturated forms of medium-/long-chain acylcarnitines were elevated in the HFrEF group. Amino acid derivatives, including 1- and 3-methylhistidine, homocitrulline and symmetric and asymmetric (ADMA) dimethylarginine were elevated in HF, with ADMA elevated uniquely in HFpEF. While the branched-chain amino acids (BCAAs) were minimally changed, short-chain acylcarnitine species indicative of BCAA catabolism were elevated in both HF groups. 3-hydroxybutyrate (3-HBA) and its metabolite, C4-OH carnitine, were uniquely elevated in the HFrEF group. Linear regression models demonstrated a significant correlation between plasma 3-HBA and N-terminal pro-brain natriuretic peptide in both forms of HF, stronger in HFrEF.
conclusionsThese results identify plasma signatures that are shared as well as potentially distinguish HFrEF and HFpEF. Metabolite markers for ketogenic metabolic re-programming were identified as unique signatures in the HFrEF group, possibly related to increased levels of BNP. Our results set the stage for future studies aimed at assessing selected metabolites as relevant biomarkers to guide HF phenotype-specific therapeutics.
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