Diagnostic Value Of Exhaled Acetone Concentration In Patients With Heart Failure And Reduced Ejection Fraction

Objective: To study the concentration of EBA in the heart failure with reduced left ventricular ejection fraction(HFrEF),and to determine the diagnostic value of EBA concentration in the heart failure with reduced left ventricular ejection fraction.Methods: From November,2015 to October,2017,we intake the 40 patients were treated as the control group with no heart failure and exclude diagnosis and 86 HfrEF patients were experimental group who were admitted to the first hospital of Lanzhou University.The breath gas from the subjects were collected about 1000 ml in Tedlar bags,The concentrations of EBA were measured by gas chromatography-mass spectrometry.The Statistical analysis was performed with SPSS 19.0 software.T test and analysis of variance were applied for difference comparison among two asmple mean.The rates of two groups was compared by chi-square test.Correlation analysis was used to analyze the correlation of variables.The receiver operation characteristic(ROC)curve was made to evaluate the sensitivity and specificity of EBA concentration in the diagnosis of patients with HFrEF.Results: We analyzed samples from 86 patients with HFrEF and 40 healthy subjects by chromatography-mass spectrometry.The EBA concentration of HFrEF group(0.59±0.34 mg/L)was obviously higher than that of control group(0.09±0.04 mg/L),the difference was statistically significant(p < 0.05).,We also observed that with the increase of the NYHA classification,EBA concentration will also increase.The EBA concentration in patients with NYHA class II was 0.39 ±0.18mg/L,EBA concentration in patients with NYHA class III was 0.58 ± 0.29 mg/L,and EBA concentration in patients with NYHA class IV was 0.83 ± 0.38mg/L,the difference among them was statistically significant(p < 0.01).Spearman correlation analysis was used to evaluate the relationship between NYHA classification and EBA concentration,and there is a strong positive correlation between them(r=0.813,p<0.0001).The area under curve of ROC was 0.981,and the EBA concentration of 0.19 mg/L is the best diagnostic cut-off for this test with the sensitivity of 95.3% and specificity of 75%.Conclusions: 1.EBA concentration in the patients with heart failure group is significantly higher than the control group,and as the deterioration of cardiac function,EBA concentration also will increase,so the EBA concentration can be used as the indicator assessing cardiac function.2.The EBA concentration could be the biomarkers of HFrEF,and has high sensitivity and specificity.3.However,it still need large sample size of clinical research to further confirmed the value of EBA in all population.