Metabolic Adaptation during Cardiac Exercise Rehabilitation in Patients after a First Myocardial Infarction

Figures

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  1. Experimental design. At the beginning and end of the CR protocol, all subjects underwent a medical examination and a series of routine clinical tests. The CR protocol lasted 6 weeks. DBS samples were collected at 6 time points pre- and post-training in three different weeks during the CR protocol: at the beginning of rehabilitation, halfway through the rehabilitation, and at the end of the rehabilitation.

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  2. Metabolic changes due to the CR program. A) Volcano plot: preinitial training (beginning of rehabilitation) vs prefinal training (end of rehabilitation) (p-value threshold 0.05, FC 1). B) Boxplots: significant changes of N-acetyl-l-tyrosine (preinitial training vs premid-program training vs prefinal training), p-value threshold 0.05.

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  3. Polar metabolites analysis. A) Volcano plots of initial training, midprogram training, and final training (p-value threshold 0.05, FC 1). −log10(p-value) is on the Y-axis and log2(FC) is on the X-axis. Green dots represent statistically significant metabolites downregulated post-training. Red dots represent statistically significant metabolites upregulated post-training. B) Overlaid quantitative enrichment analysis obtained considering the polar metabolome during initial training (red), midprogram training (green), and final training (blue). Each training implies the pre- vs post-training comparison. Each dot shows how much a single pathway is enriched in the considered comparison. The more enriched the pathway, the bigger the dot, according to the enrichment ratio, which is proportional to the number of metabolites seen in that pathway. Pathway names are shown on the Y-axis, while −log10(p-value) is on the X-axis. Only significant pathways (in at least one training) are shown.

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  4. Polar metabolome analysis. Boxplots and FC trends highlight significant changes of polar metabolites (p-value threshold 0.05). Initial training in red, midprogram training in green, and final training in blue.

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  5. Lipids analysis. A) Volcano plots of initial training, midprogram training, and final training (p-value threshold 0.05, FC 1). B) Functional analysis performed using BioPAN LipidMaps on post- vs preinitial training (T2 vs T1), with T2 chosen as the condition of interest. Reactions converting PE and PC into PS were predicted to be more active just after the initial training with z-scores of 1.929 and 2.415, respectively, predicting upregulation of PSS1 and PSS2. C) Lipid ontology enrichment analysis using LION/web, considering initial training (red), midprogram training (green), and final training (blue). Each training implies pre- vs post-training comparison. Lipid class names are shown on the Y-axis, while −log10FDR­(q-value) is on the X-axis. Dots to the right of value 0 on the X-axis represent lipid classes that are upregulated post-training. Dots to the left of value 0 on the X-axis represent lipid classes that are downregulated post-training.