, 15:57 | Cite as

Disturbed energy and amino acid metabolism with their diagnostic potential in mitral valve disease revealed by untargeted plasma metabolic profiling

  • Limiao JiangEmail author
  • Jing Wang
  • Rui Li
  • Ze-min Fang
  • Xue-Hai Zhu
  • Xin Yi
  • Hongwen Lan
  • Xiang Wei
  • Ding-Sheng JiangEmail author
Original Article



Mitral valve disease (MVD), including mitral valve regurgitation (MR) and mitral valve stenosis (MS), is a chronic and progressive cardiac malady. However, the metabolic alterations in MVD is not well-understood till now. The current gold standard diagnostic test, transthoracic echocardiography, has limitations on high-throughput measurement and lacks molecular information for early diagnosis of the disease.


The present study aimed to investigate the biochemical alterations and to explore their diagnostic potential for MVD.


Plasma metabolic profile derangements and their diagnostic potential were non-invasively explored in 34 MR and 20 MS patients against their corresponding controls, using high-throughput NMR-based untargeted metabolomics.


Eighteen differential metabolites were identified for MR and MS patients respectively, on the basis of multivariate and univariate data analysis, which were mainly involved in energy metabolism, amino acid metabolism, calcium metabolism and inflammation. These differential metabolites, notably the significantly down-regulated formate and lactate, showed high diagnostic potential for MVD by using Spearman’s rank-order correlation analysis and ROC analysis.


To the best of our knowledge, the present study is the first one that explores the metabolic derangements and their diagnostic values in MVD patients using metabolomics. The findings indicated that metabolic disturbance occurred in MVD patients, with plasma formate and lactate emerged as important candidate biomarkers for MVD.


Mitral valve regurgitation Mitral valve stenosis Metabolomics NMR Formate Lactate 



The authors gratefully acknowledge the participation of all patients and healthy controls. The authors thank Professor An Pan (HUST) for his valuable comments and constructive suggestions. The authors gratefully acknowledge Dr Junfang Wu for the kind help on language editing during manuscript revision.

Author contributions

LJ, DSJ, ZMF, XHZ and XW designed the study. JW, RL, HWL and XY collected samples. LJ conduced the NMR experiment and analyzed the metabolomics data. LJ, JW, RL, HWL and XY analyzed the data. LJ, JW, and DSJ wrote the manuscript. LJ, JW, DSJ, ZMF, XHZ and XW revised the manuscript.


This work was supported by Grants from the National Natural Science Foundation of China (Nos. 81600188, 81670050), the Natural Science Foundation of Hubei Province (No. 2016CFB162), the Tongji Hospital Fund for Distinguished Young Scholars (No. 2016YQ02), Integrated Innovative Team for Major Human Diseases Program of Tongji Medical College, Huazhong University of Science and Technology, and the start-up grant from Huazhong University of Science and Technology (513-3004513113).

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the ethics committee of Tongji Hospital, Huazhong University of Science and Technology (HUST) and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

Supplementary material

11306_2019_1518_MOESM1_ESM.docx (2.3 mb)
Supplementary material 1 (DOCX 2365 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Epidemiology and Biostatistics, MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  3. 3.Key Laboratory of Organ TransplantationMinistry of EducationWuhanChina
  4. 4.NHC Key Laboratory of Organ TransplantationWuhanChina
  5. 5.Key Laboratory of Organ TransplantationChinese Academy of Medical SciencesWuhanChina
  6. 6.Department of CardiologyRenmin Hospital of Wuhan UniversityWuhanChina
  7. 7.Cardiovascular Research InstituteWuhan UniversityWuhanChina
  8. 8.Hubei Key Laboratory of CardiologyWuhanChina

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