Анализ выдыхаемого воздуха в диагностике сердечно-сосудистых заболеваний

Анализ выдыхаемого воздуха – новый перспективный метод диагностики различных заболеваний. Состав выдыхаемого воздуха различен в норме и при патологии. В обзоре рассматриваются некоторые вещества, содержание которых меняется при сердечно-сосудистых заболеваниях, – это пентан, изопрен, окись углерода и триметиламин. Современное развитие технологий позволяет перенести анализ выдыхаемого воздуха из научно-исследовательских лабораторий в клиническую практику. Таким образом, в арсенале врачей появился новый инструмент для скрининга различных сердечно-сосудистых заболеваний в режиме реального времени.

1. Organisation mondiale de la santé. Global status report on noncommunicable diseases 2014: attaining the nine global noncommunicable diseases targets; a shared responsibility. - Geneva: World Health Organization; 298 с. ISBN 978-92-4-156485-4

2. Копылов Ф. Ю., Сыркин А. Л., Чомахидзе П. Ш., Быкова А. А., Шалтаева Ю. Р., Беляков В. В. и др. Перспективы диагностики различных заболеваний по составу выдыхаемого воздуха. Клиническая медицина. 2013;91(10):16–21

3. Amann A, Miekisch W, Schubert J, Buszewski B, Ligor T, Jezierski T et al. Analysis of Exhaled Breath for Disease Detection. Annual Review of Analytical Chemistry. 2014;7(1):455–82. DOI: 10.1146/annurev-anchem-071213-020043

4. Вакс В. Л., Домрачева Е. Г., Собакинская Е. А., Черняева М. Б. Анализ выдыхаемого воздуха: физические методы, приборы и медицинская диагностика. Успехи физических наук. 2014;184(7):739–58. DOI: 10.3367/UFNr.0184.201407d.0739

5. Карабиненко А. А., Петренко Ю. М., Ильченко Л. Ю., Надеждинский А. И., Понуровский Я. Я., Преснова Е. Д. и др. Феномены, обнаруживаемые методом диодно-лазерной спектрометрии газообразных метаболитов выдыхаемого воздуха человека при его различных функциональных состояниях. Wschodnioeuropejskie Czasopismo Naukowe (East European Scientific Journal). 2018;1-1(29):30–9

6. Золин П. П., Конвай В. Д. Измерение включения изотопной метки в выдыхаемый CO2. Биомедицина. 2017;3:60–70

7. Weitz ZW, Birnbaum AJ, Sobotka PA, Zarling EJ, Skosey JL. High breath pentane concentrations during acute myocardial infarction. Lancet (London, England). 1991;337(8747):933–5. PMID: 1678029

8. Samara MA, Tang WHW, Cikach F, Gul Z, Tranchito L, Paschke KM et al. Single Exhaled Breath Metabolomic Analysis Identifies Unique Breathprint in Patients With Acute Decompensated Heart Failure. Journal of the American College of Cardiology. 2013;61(13):1463–4. DOI: 10.1016/j.jacc.2012.12.033

9. Pabst F, Miekisch W, Fuchs P, Kischkel S, Schubert JK. Monitoring of oxidative and metabolic stress during cardiac surgery by means of breath biomarkers: an observational study. Journal of Cardiothoracic Surgery. 2007;2(1):37. DOI: 10.1186/1749-8090-2-37

10. Phillips M, Boehmer JP, Cataneo RN, Cheema T, Eisen HJ, Fallon JT et al. Heart allograft rejection: detection with breath alkanes in low levels (the HARDBALL study). The Journal of Heart and Lung Transplantation: The Official Publication of the International Society for Heart Transplantation. 2004;23(6):701–8. PMID: 15366430

11. King J, Kupferthaler A, Unterkofler K, Koc H, Teschl S, Teschl G et al. Isoprene and acetone concentration profiles during exercise on an ergometer. Journal of Breath Research. 2009;3(2):027006. DOI: 10.1088/1752-7155/3/2/027006

12. Karl T, Prazeller P, Mayr D, Jordan A, Rieder J, Fall R et al. Human breath isoprene and its relation to blood cholesterol levels: new measurements and modeling. Journal of Applied Physiology. 2001;91(2):762–70. DOI: 10.1152/jappl.2001.91.2.762

13. Mendis S, Sobotka PA, Euler DE. Expired hydrocarbons in patients with acute myocardial infarction. Free Radical Research. 1995;23(2):117–22. PMID: 7581809

14. McGrath LT, Patrick R, Silke B. Breath isoprene in patients with heart failure. European Journal of Heart Failure. 2001;3(4):423–7. PMID: 11511427

15. Bartelds B, van der Leij FR, Kuipers JR. Role of ketone bodies in perinatal myocardial energy metabolism. Biochemical Society Transactions. 2001;29(Pt 2):325–30. PMID: 11356176

16. Wende AR, Brahma MK, McGinnis GR, Young ME. Metabolic Origins of Heart Failure. JACC: Basic to Translational Science. 2017;2(3):297–310. DOI: 10.1016/j.jacbts.2016.11.009

17. Lommi J, Kupari M, Koskinen P, Näveri H, Leinonen H, Pulkki K et al. Blood ketone bodies in congestive heart failure. Journal of the American College of Cardiology. 1996;28(3):665–72. PMID: 8772754

18. Marcondes-Braga FG, Gutz IGR, Batista GL, Saldiva PHN, AyubFerreira SM, Issa VS et al. Exhaled Acetone as a New Biomarker of Heart Failure Severity. Chest. 2012;142(2):457–66. DOI: 10.1378/chest.11-2892

19. Marcondes-Braga FG, Batista GL, Gutz IGR, Saldiva PHN, Mangini S, Issa VS et al. Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF). One Year of Clinical Follow-up. PLOS ONE. 2016;11(12):e0168790. DOI: 10.1371/journal.pone.0168790

20. Yokokawa T, Sato T, Suzuki S, Oikawa M, Yoshihisa A, Kobayashi A et al. Elevated exhaled acetone concentration in stage C heart failure patients with diabetes mellitus. BMC Cardiovascular Disorders. 2017;17(1):280. DOI: 10.1186/s12872-017-0713-0

21. Bykova A. A., Kopylov Ph. Yu., Chomakhidze P. Sh., Malinovskaya L. K., Kuznetsova M. V., Betelin V. B. et al. 6042: Biomarkers of heart failure in exhaled breath. European Heart Journal. 2015;36(suppl 1):1053. [Av. at: https://academic.oup.com/eurheartj/article/36/suppl_1/849/434480. DOI: 10.1093/eurheartj/ehv401

22. Shaltaeva YR, Vasilev VK, Yakovlev DY, Kopylov FI, Syrkin AL, Chomakhidze PS et al. Detection heart failures (HF) biomarkers by proton transfer reaction - mass spectrometry and ion mobility spectrometry. IOP Conference Series: Materials Science and Engineering. 2016;151:012017. DOI: 10.1088/1757-899X/151/1/012017

23. Malinovskaya L. K., Bykova A. A., Chomakhidze P. Sh., Syrkin A. L., Kopylov Ph. Yu., Betelin V. B. et al. P1915. Mass spectrometry for detection heart failure with preserved ejection fraction. European Journal of Heart Failure. 2017;19(Suppl S1):481. [Av. at: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.833. DOI: 10.1002/ejhf.833

24. Bykova A. A., Malinovkaya L. K., Kopylov Ph. Yu., Chomakhidze P. Sh., Syrkin A. L., Betelin V. B. et al. P568. Exhaled breath analysis in diagnostics of heart failure with preserved ejection fraction. European Journal of Heart Failure. 2016;18(Suppl 1):146. [Av. at: https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.539. DOI: 10.1002/ejhf.539

25. Horváth I, MacNee W, Kelly FJ, Dekhuijzen PN, Phillips M, Döring G et al. “Haemoxygenase-1 induction and exhaled markers of oxidative stress in lung diseases”, summary of the ERS Research Seminar in Budapest, Hungary, September, 1999. The European Respiratory Journal. 2001;18(2):420–30. PMID: 11529303

26. Cheng S, Lyass A, Massaro JM, O’Connor GT, Keaney JF, Vasan RS. Exhaled Carbon Monoxide and Risk of Metabolic Syndrome and Cardiovascular Disease in the Community. Circulation. 2010;122(15):1470–7. DOI: 10.1161/CIRCULATIONAHA.110.941013

27. Tang WHW, Hazen SL. The contributory role of gut microbiota in cardiovascular disease. Journal of Clinical Investigation. 2014;124(10):4204–11. DOI: 10.1172/JCI72331

28. Huang F, Zhang F, Xu D, Zhang Z, Xu F, Tao X et al. Enterococcus faecium WEFA23 from infants lessens high-fat-diet-induced hyperlipidemia via cholesterol 7-alpha-hydroxylase gene by altering the composition of gut microbiota in rats. Journal of Dairy Science. 2018;101(9):7757–67. DOI: 10.3168/jds.2017-13713

29. Bu J, Wang Z. Cross-Talk between Gut Microbiota and Heart via the Routes of Metabolite and Immunity. Gastroenterology Research and Practice. 2018;2018:1–8. DOI: 10.1155/2018/6458094

30. Wang Z, Klipfell E, Bennett BJ, Koeth R, Levison BS, DuGar B et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature. 2011;472(7341):57–63. DOI: 10.1038/nature09922

31. Zhu W, Gregory JC, Org E, Buffa JA, Gupta N, Wang Z et al. Gut Microbial Metabolite TMAO Enhances Platelet Hyperreactivity and Thrombosis Risk. Cell. 2016;165(1):111–24. DOI: 10.1016/j.cell.2016.02.011

32. Seldin MM, Meng Y, Qi H, Zhu W, Wang Z, Hazen SL et al. Trimethylamine N-Oxide Promotes Vascular Inflammation Through Signaling of Mitogen-Activated Protein Kinase and Nuclear Factor-κB. Journal of the American Heart Association. 2016;5(2):e002767. DOI: 10.1161/JAHA.115.002767

33. Pagonas N, Vautz W, Seifert L, Slodzinski R, Jankowski J, Zidek W et al. Volatile Organic Compounds in Uremia. PLoS ONE. 2012;7(9):e46258. DOI: 10.1371/journal.pone.0046258