Breathome discriminate Ischemic Heart Disease

Abstract

AbstractBackgroundIschemic heart disease (IHD) impacts the quality of life and has the highest mortality rate in between other cardiovascular disease in the globe.ObjectivesIHD early diagnosis, management, and prevention remain underestimated due to the poor diagnostic and therapeutic strategies including the early prevention methods.AimsTo assess the changes in the exhaled breath analysis, volatile organic compounds (VOCs), in patients with ischemic heart disease confirmed by stress computed tomography myocardial perfusion (CTP) imaging.Materials and methodsA single center observational study included 80 participants from Moscow. The participants aged ≥ 40 years and given a written consent to participate in the study. Both groups, G1=31 with vs G2=49 without post stress induced myocardial perfusion defect, passed cardiologist consultation, anthropometric measurements, blood pressure and pulse rate, echocardiography, real time breathing at rest into PTR-TOF-MS-1000, cardio-ankle vascular index, performing bicycle ergometry, and immediately after performing bicycle ergometry repeating the breathing analysis into the PTR-TOF-MS-1000, and after three minutes from the second breath, repeat the breath into the PTR-TOF-MS-1000, then performing CTP. LASSO regression with nested cross-validation was used to find association between VOCs and existence of perfusion defect. Statistical processing was carried out using the R programming language v4.2 and Python v.3.10 [^R], STATISTICA, and IBM SPSS.ResultsThe specificity 77.6 % [95 % confidence interval (CI); 0.666; 0.889], sensitivity 83.9 % [95 % CI; 0.692; 0.964], and accuracy of the diagnostic method using exhaled breath analysis, area under the curve (AUC) 83.8 % [95 % CI; 0.73655857; 0.91493173]. Whereas, the AUC of the bicycle ergometry 50.7 % [95 % CI; 0.388; 0.625], specificity 53.1 % [95 % CI; 0.392; 0.673], and sensitivity 48.4 % [95 % CI; 0.306; 0.657].ConclusionVOCs analysis appear to discriminate individuals with and without IHD with clinically acceptable diagnostic accuracy.OtherThe exhaled breath analysis reflects the myocardiocytes metabolomic signature and related intercellular homeostasis changes and regulation perturbances. Exhaled breath analysis poses a promise result to improve the diagnostic accuracy of the physical stress tests.