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Updated: Aug 13, 2025
Fast and Accurate Exhaled Breath Ammonia Measurement
Published on: June 11, 2014
Metabolomics and a Breath Sensor Identify Acetone as a Biomarker for Heart Failure
Patrick A Gladding1,2, Maxine Cooper1, Renee Young1
1Cardiology Department, Waitemata District Health Board, Auckland 0620, New Zealand.
Background:
Multi-omics delivers more biological insight than targeted investigations. We applied multi-omics to patients with heart failure with reduced ejection fraction (HFrEF).
Methods:
46 patients with HFrEF and 20 controls underwent metabolomic profiling, including liquid/gas chromatography mass spectrometry (LC-MS/GC-MS) and solid-phase microextraction (SPME) volatilomics in plasma and urine. HFrEF was defined using left ventricular global longitudinal strain, ejection fraction and NTproBNP. A consumer breath acetone (BrACE) sensor validated results in n = 73.
Results:
28 metabolites were identified by GCMS, 35 by LCMS and 4 volatiles by SPME in plasma and urine. Alanine, aspartate and glutamate, citric acid cycle, arginine biosynthesis, glyoxylate and dicarboxylate metabolism were altered in HFrEF. Plasma acetone correlated with NT-proBNP (r = 0.59, 95% CI 0.4 to 0.7), 2-oxovaleric and cis-aconitic acid, involved with ketone metabolism and mitochondrial energetics. BrACE > 1.5 ppm discriminated HF from other cardiac pathology (AUC 0.8, 95% CI 0.61 to 0.92, p < 0.0001).
Conclusion:
Breath acetone discriminated HFrEF from other cardiac pathology using a consumer sensor, but was not cardiac specific.
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