Cardiogenic Shock Integrated PHenotyping for Event Reduction: A Pilot Metabolomics Analysis

Area of Science:

• Biochemistry
• Cardiology
• Metabolomics

Background:

• Cardiogenic shock (CS) is a severe condition with high mortality.
• Hypoperfusion in CS can lead to uncontrolled inflammation and metabolic issues.
• Understanding metabolic shifts is crucial for improving outcomes in heart failure with CS (HF-CS).

Purpose of the Study:

• To investigate metabolomic profiles in patients with HF-CS.
• To analyze temporal changes in specific biomarkers (IL-6, Ang-2, glycocalyx markers) from admission to discharge.
• To identify metabolic signatures associated with survival or mortality in HF-CS.

Main Methods:

• Studied 18 consecutive HF-CS patients.
• Collected biological samples at admission (T0), 48 hours (T1), and discharge (T2).
• Utilized ELISA and targeted metabolomics for analysis.

Main Results:

• In-hospital mortality was 44% (7 out of 18 patients).
• Survivors showed significant reductions in IL-6 and kynurenine by discharge.
• Survivors exhibited significant increases in amino acids (arginine, threonine, glycine, lysine, asparagine), putrescine, sphingolipids, and glycerophospholipids.

Conclusions:

• HF-CS patients display a unique metabolomic profile.
• Metabolic fingerprints may guide personalized treatment strategies for HF-CS.
• Temporal metabolic changes in survivors indicate shifts in metabolic pathways during recovery.