Altered Carnitine Metabolism in Ischemic and Non-Ischemic Cardiomyopathy: A Comparative Metabolomics Study Using...

Area of Science:

• Biochemistry
• Metabolomics
• Cardiology

Background:

• Cardiomyopathy, a leading cause of heart failure, encompasses ischemic (IC) and non-ischemic (NIC) types with unique mechanisms.
• Carnitine is vital for mitochondrial fatty acid transport and β-oxidation; its dysregulation is linked to cardiomyopathy.
• Comparative carnitine and acylcarnitine profiles between IC and NIC are not well-established.

Purpose of the Study:

• To comparatively analyze serum carnitine and acylcarnitine profiles in IC and NIC patients.
• To identify distinct metabolic signatures differentiating IC and NIC.
• To evaluate the diagnostic potential of acylcarnitines in cardiomyopathy.

Main Methods:

• Serum samples from 40 IC patients, 40 NIC patients, and 40 controls were analyzed.
• Quantification of free carnitine and 27 acylcarnitine species using LC-MS/MS.
• Multivariate (PCA, PLS-DA) and univariate (ANOVA) statistical analyses, including ROC curves, were employed.

Main Results:

• IC patients had lower short- and medium-chain acylcarnitines (e.g., C2, C14) compared to controls.
• NIC patients exhibited higher medium- and long-chain acylcarnitines (e.g., C6DC, C16).
• Metabolites C2, C6DC, and C16 were key discriminators; ROC analysis showed modest diagnostic performance (AUC 0.623-0.635).

Conclusions:

• Distinct serum carnitine profiles characterize IC and NIC, reflecting differential metabolic remodeling.
• These findings may elucidate disease mechanisms and identify potential biomarkers or therapeutic targets.
• Acylcarnitine profiling shows promise for supporting differential diagnosis and personalized management of cardiomyopathy.