Background: Heart failure (HF) is a complex syndrome caused by structural and/or functional abnormalities of the heart and a main cause of mortality and poor quality of life in western societies. HF patients are periodically hospitalized due to the exacerbation of symptoms, but prevention of acute conditions would slow down the disease progression. The painless and non-invasive breath analysis is an attractive monitoring tool that could support conventional clinical investigations. We present an innovative method to monitor exhaled breath VOCs in HF patients based on Needle Trap Micro-Extraction coupled to GC-MS/MS analysis. Methods: The analytical performances of triple-bed NTDs, packed with 1 cm of each Divinylbenzene, Carbopack X and Carboxen 1000, were evaluated by analyzing a humidified standard gaseous mixture of 22 VOCs (i.e. hydrocarbons, ketones, aldehydes, aromatics and sulfurs). An aliquot (25 mL) of end-tidal breath sample was collected at 15 mL/min from 40 HF patients at hospital admission and every 48 h until discharge. NTDs were thermally desorbed at 250 °C for 30 s in the GC inlet and VOCs analyzed by GC-MS/MS. Results: Detection limits between 20 and 500 pptv were assessed for most VOCs by pre-concentrating 25 mL of a humidified standard gas mixture at a flow rate of 15 mL/min. Inter- and intra-day precisions, always below 15% for all compounds, confirmed the reliability of the method. About 80% of patients showed significantly decreased breath acetone levels (a factor of 3 or higher) at discharge compared to admission (acute phase), in correspondence to improved clinical conditions. This result makes acetone an eligible biomarker of heart failure exacerbation. Conclusions: A very reliable analytical procedure for the determination of VOCs in exhaled breath by NTME followed by GC-MS/MS analysis was developed. Results highlighted the potential role of breath acetone for monitoring the health conditions of HF patients.
Determination of volatile organic compounds in exhaled breath of heart failure patients by needle trap micro-extraction coupled with gas chromatography-tandem mass spectrometry
Fabio Di Francesco
;Tommaso Lomonaco;Denise Biagini;Silvia Ghimenti;Massimo Onor;Pietro Salvo;Maria G. Trivella;Roger Fuoco
2018-01-01
Abstract
Background: Heart failure (HF) is a complex syndrome caused by structural and/or functional abnormalities of the heart and a main cause of mortality and poor quality of life in western societies. HF patients are periodically hospitalized due to the exacerbation of symptoms, but prevention of acute conditions would slow down the disease progression. The painless and non-invasive breath analysis is an attractive monitoring tool that could support conventional clinical investigations. We present an innovative method to monitor exhaled breath VOCs in HF patients based on Needle Trap Micro-Extraction coupled to GC-MS/MS analysis. Methods: The analytical performances of triple-bed NTDs, packed with 1 cm of each Divinylbenzene, Carbopack X and Carboxen 1000, were evaluated by analyzing a humidified standard gaseous mixture of 22 VOCs (i.e. hydrocarbons, ketones, aldehydes, aromatics and sulfurs). An aliquot (25 mL) of end-tidal breath sample was collected at 15 mL/min from 40 HF patients at hospital admission and every 48 h until discharge. NTDs were thermally desorbed at 250 °C for 30 s in the GC inlet and VOCs analyzed by GC-MS/MS. Results: Detection limits between 20 and 500 pptv were assessed for most VOCs by pre-concentrating 25 mL of a humidified standard gas mixture at a flow rate of 15 mL/min. Inter- and intra-day precisions, always below 15% for all compounds, confirmed the reliability of the method. About 80% of patients showed significantly decreased breath acetone levels (a factor of 3 or higher) at discharge compared to admission (acute phase), in correspondence to improved clinical conditions. This result makes acetone an eligible biomarker of heart failure exacerbation. Conclusions: A very reliable analytical procedure for the determination of VOCs in exhaled breath by NTME followed by GC-MS/MS analysis was developed. Results highlighted the potential role of breath acetone for monitoring the health conditions of HF patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
