Abstract
BackgroundHypertrophic cardiomyopathy (HCM) is a common inherited heart disorder complicated by left ventricle outflow tract (LVOT) obstruction, which can be treated with surgical myectomy. To date, no reliable biomarkers for LVOT obstruction exist. We hypothesized that metabolomic biomarkers for LVOT obstruction may be detectable in plasma from HCM patients.MethodsWe conducted metabolomic profiling on plasma samples of 18 HCM patients before and after surgical myectomy, using a commercially available metabolomics platform.ResultsWe found that 215 metabolites were altered in the postoperative state (p-value < 0.05). 12 of these metabolites were notably significant after adjusting for multiple comparisons (q-value < 0.05), including bilirubin, PFOS, PFOA, 3,5-dichloro-2,6-dihydroxybenzoic acid, 2-hydroxylaurate, trigonelline and 6 unidentified compounds, which support improved organ metabolic function and increased lean soft tissue mass.ConclusionsThese findings suggest improved organ metabolic function after surgical relief of LVOT obstruction in HCM and further underscore the beneficial systemic effects of surgical myectomy.
Highlights
Hypertrophic cardiomyopathy (HCM) is a common inherited heart disorder complicated by left ventricle outflow tract (LVOT) obstruction, which can be treated with surgical myectomy
We have recently reported that surgical myectomy in HCM patients with LVOT obstruction is associated with changes in the plasma proteome consistent with reduction in systemic inflammation and improvement in physiological function, suggesting significant benefits beyond hemodynamic improvement [4]
HCM patients referred for surgical myectomy at Tufts Medical Center were approached consecutively and those that gave consent and planned to return for a postoperative visit were enrolled
Summary
Hypertrophic cardiomyopathy (HCM) is a common inherited heart disorder complicated by left ventricle outflow tract (LVOT) obstruction, which can be treated with surgical myectomy. We have recently reported that surgical myectomy in HCM patients with LVOT obstruction is associated with changes in the plasma proteome consistent with reduction in systemic inflammation and improvement in physiological function, suggesting significant benefits beyond hemodynamic improvement [4]. To further explore this concept and to identify potential metabolite biomarkers, we investigated metabolomic changes between the pre- and post-surgical patient states
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