Low Serum Lysophospholipids Predict Increased In-Hospital Mortality in Patients With Acute Heart Failure

Area of Science:

• Cardiovascular Research
• Biomarker Discovery
• Metabolomics

Background:

• Acute heart failure (AHF) necessitates improved risk prediction strategies.
• Novel biomarkers are crucial for identifying high-risk AHF patients.

Purpose of the Study:

• To identify serum lipids with prognostic value in AHF.
• To assess the clinical utility of these lipids for risk stratification.

Main Methods:

• Targeted mass spectrometry-based lipidomics on serum samples from 315 (discovery) and 139 (validation) AHF patients.
• Utilized orthogonal partial least squares discriminant analysis, least absolute shrinkage and selection operator regression, and random forest (Boruta) for lipid identification.
• Employed TopKSignal to rank prognostic lipids based on consolidated analytical results.

Main Results:

• Lysophosphatidylethanolamine 20:4, lysophosphatidylcholine 20:4, lysophosphatidylcholine 14:0, and lysophosphatidylethanolamine 18:1 were strongly associated with in-hospital mortality.
• Lower serum concentrations of these lipids were observed in non-survivors, with consistent inverse associations across cohorts.
• These lipids offered moderate discriminative performance and added prognostic value beyond established risk scores (ADHERE, GWTG-HF, OPTIMIZE-HF).

Conclusions:

• Specific lysophospholipids (lysoPE 20:4, lysoPC 20:4, lysoPC 14:0, lysoPE 18:1) are independently associated with in-hospital mortality in AHF.
• These findings suggest potential novel prognostic biomarkers for acute heart failure.
• Further validation in larger cohorts is warranted to confirm clinical applicability.