The Study Of The Urine Metabolomics Features Of Ischemic Heart Failure Which Divided Into Syndrome Of Blood Stasis Caused By Qi Deficiency And Syndrome Of Accumulation Of Fluid Caused By Yang Deficiency

Background:With the deepening research of traditional Chinese medicine, Chinese medicine treatment of heart failure has made obvious progress, especially in improving Patients with clinical symptoms, the control course of development, improve the quality of life in patients with prominent advantages. But there are also many problems, such as the nature Of the syndrome of traditional Chinese medicine research is not enough, which makes the heart lack of specification and lack of standard, has affected the clinical physicians evidence-based medicine for chronic heart failure.Objective:To study the urine metabolomics features of chronic heart failure and healthy group as well as chronic heart failure which divided into syndrome of blood stasis caused by Qi deficiency (QDBS) and syndrome of accumulation of fluid caused by Yang deficiency(YDFA), to search for Metabolite spectrum, to explore its metabolic pathways, and finally provide objective basis for heart failure of dialectical classification.Methods:1. Based on liquid chromatography-mass spectrometry (LC-MS) metabolomics detection technology, through principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA) methods, we study the urine sample of18cases of healthy volunteers and36cases with standard heart failure patients, from the LC-MS we can conclude Accurate molecular weight of potential biological markers and indentify the potential biological markers, analyze its Metabolite spectrum and search for specific metabolic substance groups related to its syndromes.2. Analysis Metabolic pathways of patients with chronic heart failure and chronic heart failure of both QDBS and YDFA in the whole to provide a reference for heart failure of dialectical classification.Result:1. There is a distinctive differences between healthy group and ischemia heart failure group, potential biomarkers through MS/MS experiment or identfication standard of comparison, the results found12potential biomarker composition. Compare to the healthy group, The substance content such as2-Aminoadipic acid, allysine, Histidine, Homoarginine, Symmetric dimethylarginine, Anandamide (20:2, n-6) have a decline in the heart failure patients, its related metabolic pathways respectively lysine metabolism, histidine metabolism, arachidonic acid metabolism and others. whereas there is a rise in Phytosphingosine, C16Sphinganine, Dihydrosphingosine, Threoneopterin, primapterin and Mannitol in the heart failure patients, its related metabolic pathways respectively sphingolipid metabolism, Neoperin metabolism, tetrahydrobiopterin metabolism.2. There is a certain differences between Qi deficiency and blood stasis syndrome group and Yang deficiency of water stop group, we found6potential biomarker composition. Compare to Qi deficiency and blood stasis syndrome group, The substance content such as Arginine, Pantothenic Acid,2-Aminoadipic acid, Aspartylglycosamine,2-pentadecenoic acid have a decline in the Yang deficiency of water stop group, its related metabolic pathways respectively arginine metabolism, energy metabolism, lysine metabolism, fatty acid metabolism and others. Whereas there is a rise in GPCho(16:0/3:1) in the Yang deficiency of water stop group, the major metabolic pathways is phospholipid metabolism. There is a close contact of arginine metabolism and heart failure.Conclusion:1. There is a distinctive difference of metabolic profiling urine between chronic heart failure and healthy group as well as chronic heart failure of both QDBS and YDFA group.2. The potential markers are found in the urine of patients with chronic heart failure such as histidine, arginine, anandamide, sphingolipid component.3. The potential markers are found in the urine of patients with chronic heart failure YDFA such as Arginine, Pantothenic Acid, GPCho(16:0/3:1).4. Qi deficiency and blood stasis syndrome and Yang deficiency of water stop in metabolic pathway have differences (p<0.05). metabonomics studies for chronic heart failure objective to provide theoretical basis for syndrome differentiation of syndromes.