Plasma metabolomics combined with personalized diagnosis guided by Chinese medicine reveals subtypes of chronic heart failure

Abstract

Background: Chronic heart failure (CHF) is characterized by insufficient blood supply from heart to meet the body's metabolic demands. Integrating Western and traditional Chinese medicine to treat CHF has proved a validated therapeutic approach. In recent years, metabolomics has been regarded as a potential platform to provide biomarkers for disease-subtypes. Objective: To examine 38 patients, combined NMR plasma metabolomics and traditional Chinese medicine diagnosis in order to identify diagnostic biomarkers for two CHF syndrome subtypes. Methods: After processing the spectra, orthogonal partial least square discriminant analysis was performed, and the contributing NMR signals were analyzed using Y-scrambling statistical validation with good reliability. Results: Plasma metabolic patterns of yin deficiency and yang deficiency patients were clearly discriminated. The yin-deficiency group had increased level of lactate, glycoprotein, lipoprotein and lower levels of glucose, valine and proline. The yang-deficiency group had higher levels of lactate, glycoprotein and pyruvic acid, and lower levels of glucose and lipoprotein. Potential biomarkers of CHF based on the two traditional Chinese medicine syndromes indicated alternative modes of metabolites and metabolic pathways in the disease, e.g. dysfunction of energy utilization and disturbance in fatty acids, amino acids. Conclusion: This study suggests that combining metabolomics with traditional Chinese medicine diagnosis can reveal metabolic signatures for CHF syndrome subtypes. The plasma metabolites identified might be of special clinical relevance for subtypes of CHF, which could lead to further understanding of mechanisms involved and an improvement in personalized treatment for CHF.

Keywords

• Metabolomics
• Chinese medicine
• Chronic heart failure