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- Gladding, PA, et al.
(författare)
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Metabolomics and a Breath Sensor Identify Acetone as a Biomarker for Heart Failure
- 2023
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Ingår i: Biomolecules. - : MDPI AG. - 2218-273X. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multi-omics delivers more biological insight than targeted investigations. We applied multi-omics to patients with heart failure with reduced ejection fraction (HFrEF). Methods: 46 patients with HFrEF and 20 controls underwent metabolomic profiling, including liquid/gas chromatography mass spectrometry (LC-MS/GC-MS) and solid-phase microextraction (SPME) volatilomics in plasma and urine. HFrEF was defined using left ventricular global longitudinal strain, ejection fraction and NTproBNP. A consumer breath acetone (BrACE) sensor validated results in n = 73. Results: 28 metabolites were identified by GCMS, 35 by LCMS and 4 volatiles by SPME in plasma and urine. Alanine, aspartate and glutamate, citric acid cycle, arginine biosynthesis, glyoxylate and dicarboxylate metabolism were altered in HFrEF. Plasma acetone correlated with NT-proBNP (r = 0.59, 95% CI 0.4 to 0.7), 2-oxovaleric and cis-aconitic acid, involved with ketone metabolism and mitochondrial energetics. BrACE > 1.5 ppm discriminated HF from other cardiac pathology (AUC 0.8, 95% CI 0.61 to 0.92, p < 0.0001). Conclusion: Breath acetone discriminated HFrEF from other cardiac pathology using a consumer sensor, but was not cardiac specific.
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| 2. |
- Gladding, PA, et al.
(författare)
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Multiomics, virtual reality and artificial intelligence in heart failure
- 2021
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Ingår i: Future cardiology. - : Future Medicine Ltd. - 1744-8298 .- 1479-6678. ; 17:8, s. 1335-1347
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Multiomics delivers more biological insight than targeted investigations. We applied multiomics to patients with heart failure (HF) and reduced ejection fraction (HFrEF), with machine learning applied to advanced ECG (AECG) and echocardiography artificial intelligence (Echo AI). Patients & methods: In total, 46 patients with HFrEF and 20 controls underwent metabolomic profiling, including liquid/gas chromatography–mass spectrometry and solid-phase microextraction volatilomics in plasma and urine. HFrEF was defined using left ventricular (LV) global longitudinal strain, EF and N-terminal pro hormone BNP. AECG and Echo AI were performed over 5 min, with a subset of patients undergoing a virtual reality mental stress test. Results: A-ECG had similar diagnostic accuracy as N-terminal pro hormone BNP for HFrEF (area under the curve = 0.95, 95% CI: 0.85–0.99), and correlated with global longitudinal strain (r = -0.77, p < 0.0001), while Echo AI-generated measurements correlated well with manually measured LV end diastolic volume r = 0.77, LV end systolic volume r = 0.8, LVEF r = 0.71, indexed left atrium volume r = 0.71 and indexed LV mass r = 0.6, p < 0.005. AI-LVEF and other HFrEF biomarkers had a similar discrimination for HFrEF (area under the curve AI-LVEF = 0.88; 95% CI: -0.03 to 0.15; p = 0.19). Virtual reality mental stress test elicited arrhythmic biomarkers on AECG and indicated blunted autonomic responsiveness (alpha 2 of RR interval variability, p = 1 × 10-4) in HFrEF. Conclusion: Multiomics-related machine learning shows promise for the assessment of HF.
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| 3. |
- Roden-Jullig, A, et al.
(författare)
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Antithrombin-III activity and the efficacy of heparin in progressing ischemic stroke
- 1998
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Ingår i: CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS. - : SAGE Publications. - 1076-0296 .- 1938-2723. ; 4:2, s. 129-132
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Heparin is often used in progressing ischemic stroke. However, a substantial part of the patients continue to progress while on treatment. The purpose of this study was to evaluate if antithrombin (AT) III activity before treatment could predict patients at risk for continued progression or if heparin-induced reduction in AT-III activity during treatment is related to continued progression. The study included 42 acute stroke patients with heaprin treatment for progression of isch emic stroke. The patients were continuously supervised for progression. Intravenous heparin therapy was started as soon as possible after the progression was noticed. Antithrombin-III activity was assessed before initiation of treatment and daily during the treatment period. Nine (21 %) of the 42 patients continued to progress while on treatment. There was no statis tically significant difference in AT III activity before treatment between patients who continued to progress and those where the progression ceased when treatment was initiated. Nor were there any differences in the mean AT III activity levels during treatment for patients with more or less favorable clinical course. The individual changes (Δ AT III) were similar in both patient groups as was the proportion of patients with their low est AT III activity in the thrombogenic range (continued: 22% vs. ceased: 27%). No clinically relevant influence of AT III activity on heparin efficacy in progressing ischemic stroke was found. Key Words: Stroke progression—Heparin treatment— Antithrombin activity.
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