Metabolite profiles outperformed NT-proBNP in predicting load-independent measures of right ventricular function at rest and cardiopulmonary system performance under stress in patients with PAH.
Cohort
Do specific metabolite profiles predict right ventricular function and exercise performance better than NT-proBNP in patients with pulmonary arterial hypertension?
Specific metabolite profiles, particularly involving tryptophan and arginine pathways, outperform NT-proBNP in predicting right ventricular function and exercise performance in patients with pulmonary arterial hypertension.
In this cohort of patients with pulmonary arterial hypertension (PAH), we investigate metabolomic associations with comprehensive right ventricular (RV) functional measurements derived from multibeat RV pressure-volume loop analysis. Our results show that tryptophan metabolism, particularly the kynurenine pathway, is linked to intrinsic RV function and PAH pathobiology. Findings also highlight the importance of arginine bioavailability in the cardiopulmonary system's response to exercise stress. Metabolite profiles selected via unbiased analysis outperformed N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) in predicting load-independent measures of RV function at rest and cardiopulmonary system performance under stress. Overall, this work suggests the potential for select metabolites to function as disease-specific biomarkers, offers insights into PAH pathobiology, and informs discovery of potentially targetable RV-centric pathways.
Simpson et al. (Tue,) conducted a cohort in pulmonary arterial hypertension. Metabolite profiles vs. NT-proBNP was evaluated on load-independent measures of RV function at rest and cardiopulmonary system performance under stress. Metabolite profiles outperformed NT-proBNP in predicting load-independent measures of right ventricular function at rest and cardiopulmonary system performance under stress in patients with PAH.