Biomedicines (Nov 2024)

A Metabolomic Approach to Unexplained Syncope

  • Susanna Longo,
  • Ilaria Cicalini,
  • Damiana Pieragostino,
  • Vincenzo De Laurenzi,
  • Jacopo M. Legramante,
  • Rossella Menghini,
  • Stefano Rizza,
  • Massimo Federici

DOI
https://doi.org/10.3390/biomedicines12112641
Journal volume & issue
Vol. 12, no. 11
p. 2641

Abstract

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Background: This study aims to identify a metabolomic signature that facilitates the classification of syncope and the categorization of the unexplained syncope (US) to aid in its management. Methods: We compared a control group (CTRL, n = 10) with a transient loss of consciousness (TLC) group divided into the OH group (n = 23) for orthostatic syncope, the NMS group (n = 26) for neuromediated syncope, the CS group (n = 9) for cardiological syncope, and the US group (n = 27) for US defined as syncope without a precise categorization after first- and second-level diagnostic approaches. Results: The CTRL and the TLC groups significantly differed in metabolic profile. A new logistic regression model has been developed to predict how the US will be clustered. Using differences in lysophosphatidylcholine with 22 carbon atom (C22:0-LPC) levels, 96% of the US belongs to the NMS and 4% to the CS subgroup. Differences in glutamine and lysine (GLN/LYS) levels clustered 95% of the US in the NMS and 5% in the CS subgroup. Conclusions: We hypothesize a possible role of C22:0 LPC and GLN/LYS in re-classifying US and differentiating it from cardiological syncope.

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