Clinical Role Of Exhaled Breath Acetone In Patients With Chronic Heart Failure With Preserved Ejection Fraction

Objective To analyze exhaled breath acetone(EBA)concentrations in patients with chronic heart failure with preserved ejection fraction(HF-pEF)retention,and its association with N-terminal pro-brain natriuretic peptide(NT-proBNP),NYHA functional class,left atrial diameter(LAD)),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF)correlation,and its clinical value.Methods A total of 78 patients with HF-PEF,grade ?(n = 27),group ? with cardiac function(n = 29)and group ? with cardiac function(n = 22)were enrolled in this study.Patients with normal function as a control group.EBA levels,NT-proBNP levels and echocardiographic parameters LAD ?LVEDV and LVEF were measured.Use SPSS21.0 software for data processing database analysis.Results(1)between the two groups of Age,sex,body mass index(BMI),heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),history of coronary heart disease,hemoglobin(HB),total cholesterol(TC),low density LDL-C and Hcy were not significantly different(P>0.05).Compared with the control group,the history of coronary heart disease,history of atrial fibrillation,and creatinine(Cr),uric acid(UA)were significantly different in the HF-PEF group(P < 0.05).HF-PEF Angiotensin Converting Enzyme Inhibitor(ACEI)or Angiotensin Receptor Blocker(ARB),Beta Blocker(?-B),Loop Diuretic,Mineralocorticoid Receptor Antagonist Use more often.(2)Compared with the control group,EBA concentration in HF-pEF group [0.45(0.05-1.12)mg/L vs.0.11(0.01-0.40)mg/L,P<0.05],NT-proBNP,LAD were significantly increased(P<0.05),LVEDV,LVEF were decreased(P<0.05).(3)The area under the ROC curve plotted with EBA level was 0.835(95% CI: 0.761-0.908,P<0.001).The best cut-off value for EBA diagnosis of HF-pEF was 0.18 mg/L(sensitivity 76.9%,Specificity 86.5%).(4)EBA level increased with the increase of cardiac function grade,and was positively correlated with NT-proBNP,LAD,and NYHA grades.The correlation coefficients were 0.705,0.272,0.258,and 0.488,respectively(P<0.05).There was no difference between LVEDV and LVEF.Correlation(P>0.05).Conclusions Compared with the control group,the EBA level of HF-pEF patients was significantly increased.EBA has certain reference significance for the diagnosis of HF-pEF and is related to the severity of HF-pEF.