Analysis of Metabolic Markers in Patients with Chronic Heart Failure before and after LVAD Implantation

Figures

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  Figure 1. Time course of laboratory and clinical markers before and after LVAD implantation of HF (I), DCM (II), and ICM (III). (A) LV-EF levels of control (n = 20) vs. HF (n = 40), control vs. DCM (n = 20), and control vs. ICM (n = 20), all with pre-LVAD and 30 days post-LVAD. Depicted are min, max, median, and single values. Significance was calculated with a t-test or the Mann–Whitney U test. * indicates significant to control (*** = p < 0.001). # indicates significant to pre-LVAD (## = p < 0.01). (B) LVEDD levels of control vs. HF, control vs. DCM, and control vs. ICM, all with pre-LVAD and 30 days post-LVAD. Depicted are min, max, median, and single values. Significance was calculated with a t-test or the Mann–Whitney U test * indicates significant to control (** = p<0.01, *** = p < 0.001). # indicates significant to pre-LVAD (# = p < 0.05, ## = p < 0.01, ### = p < 0.001). (C) BNP levels of control vs. HF, control vs. DCM, and control vs. ICM all with pre-LVAD, 30 days post-LVAD, and >100 days post-LVAD. Depicted are mean values and standard deviation. Significance was calculated with a t-test or the Mann–Whitney U test * indicates significant to control (*** = p < 0.001). # indicates…

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  Figure 2. Comparison of metabolic parameters between control and HF. (A) Principal component analysis of all patients and control (red) vs. pre-LVAD HF (green), depicting overlapping and dispersing patients with four outliers. (B) Heatmap visualization of the 63 significantly altered metabolites between control and HF. Colors indicate the concentration of the respective metabolite. Columns signify samples, and rows metabolites.

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  Figure 3. Comparison of significant metabolic parameters of DCM and ICM pre-LVAD. (A) PCA of pre-LVAD DCM vs. pre-LVAD ICM significantly different metabolites. (B) Heatmap visualization of the seven metabolites significantly different between DCM and ICM pre-LVAD. (C) I–IV Amino acid levels of pre-LVAD DCM vs. pre-LVAD ICM. Depicted are min, max, median, and single values. Significance was calculated with a t-test) or the Mann–Whitney U test). * indicates significant to DCM (*** = p < 0.001) (D) I–III Biogenic amine levels of pre-LVAD DCM vs. pre-LVAD ICM. Depicted are min, max, median, and single values. Significance was calculated with a t-test or the Mann–Whitney U test. * indicates significant to DCM (*** = p < 0.001).

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  Figure 4. Comparison of significant metabolic parameters of DCM and ICM >100 days post-LVAD. (A) PCA of the significantly different metabolites >100 days post-LVAD DCM vs. >100 days post-LVAD ICM. (B) Heatmap visualization of the four metabolites significantly different between DCM and ICM >100 days post-LVAD. (C) I–IV C12-DC, Gly, spermidine, and SM C24:0 levels >100 days post-DCM vs. >100 days post-LVAD ICM. Depicted are min, max, median, and single values. Significance was calculated with a t-test) or the Mann–Whitney U test). * indicates significant to DCM (*** = p < 0.001).

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  Figure 5. Time-course changes of C2, Pro, and lysoPC a C17:0 in HF, DCM, and ICM. (A) I–III C2 levels of control vs. HF, DCM, and ICM with pre-LVAD, 30 days post-LVAD, and >100 days post-LVAD. Depicted are min, max, median, and single values. Significance was calculated with a t-test or the Mann–Whitney U test * indicates significant to control (* = p < 0.05, ** = p < 0.01, *** = p < 0.001). # indicates significant to pre-LVAD (# = p < 0.05). (B) I–III Pro levels of control vs. HF, DCM, and ICM all with pre-LVAD, 30 days post-LVAD, and >100 days post-LVAD. Depicted are min, max, median, and single values. Significance was calculated with a t-test or the Mann–Whitney U test * indicates significant to control (* = p < 0.05, ** = p < 0.01, *** = p < 0.001). # indicates significant to pre-LVAD (### = p < 0.001). (C) I–III lysoPC a C17:0 levels of control vs. HF, DCM, and ICM all with pre-LVAD, 30 days post-LVAD, and >100 days post-LVAD. Depicted are min, max, median, and single values. Significance was calculated with a t-test or the Mann–Whitney U test * indicates significant to control (** = p < 0.01, *** = p < 0.001). # indicates significant to pre-LVAD (# = p < 0.05, ## = p < 0.01).