Skip to main content
SpringerLink
Log in

Metabonomics: A Useful Tool to Reveal Underlying Relationships between Altered Chinese Medicine Syndromes and Ultrafiltration in Treatment of Heart Failure

  • Original Article
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Objective

To reveal the underlying relationships between Chinese medicine (CM) syndromes and ultrafiltration (UF) in the treatment of heart failure based on a metabonomic approach.

Methods

Seventeen acute decompensated heart failure (ADHF) patients were enrolled, and their CM syndromes before and after UF were collected. In addition, their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis. Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples. Partial least-squares to latent structure-discriminant analyses were used for data analysis.

Results

An obvious difference was observed pre- and post-treatment. A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine, 1-methylhistidine, phytosphingosine, O-decanoyl-R-carnitine, etc. were screened out, showing a significant change after UF. The major adjusted metabolic pathways were purine metabolism, histidine metabolism, leucine and isoleucine metabolism, arginine and proline metabolism, carnitine shuttle, sphingolipid metabolism and phospholipid metabolism.

Conclusions

Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Marenzi G, Muratori M, Cosentino ER, Rinaldi ER, Donghi V, Milazzo V, et al. Continuous ultrafiltration for congestive heart failure: the CUORE trial. J Card Fail 2014;20:9–17.

    Article  Google Scholar 

  2. Ambrosy AP, Pang PS, Sadiya K, Konstam MA, Fonarow GC, Brian T, et al. Clinical course and predictive value of congestion during hospitalization in patients admitted for worsening signs and symptoms of heart failure with reduced ejection fraction: findings from the EVEREST trial. Eur Heart J 2013;34:835–843.

    Article  Google Scholar 

  3. Felker GM, O’Connor CM, Braunwald E. Loop diuretics in acute decompensated heart failure necessary? Evil? A necessary evil? Circ Heart Fail 2009;2:56.

    Article  Google Scholar 

  4. Krum H, Cameron P. Diuretics in the treatment of heart failure: mainstay of therapy or potential hazard? J Card Fail 2006;12:333–335.

    Article  CAS  Google Scholar 

  5. Dong Y, Ma XC, Feng XQ. The treatment of ultrafiltration to the diuretic resistance in patients with refractory heart failure and the influence of pattern of syndrome distribution. Chin Circ J (Chin) 2014;29 (Supple):194.

    Google Scholar 

  6. Jiang TT, Li JC. Review on the systems biology research of yin-deficiency-heat syndrome in traditional Chinese medicine. Anat Re (Hoboken) 2020.期? 页码?

  7. Nicholson JK, Wilson ID. Opinion: understanding ‘global’ systems biology: metabonomics and the continuum of metabolism. Nat Rev Drug Discov 2003;2:668–676.

    Article  CAS  Google Scholar 

  8. Jian Z, Hui ZY. 2014 China Guidelines for the diagnosis and management of heart failure. Chin J Cardiol (Chin) 2014;42:98–122.

    Google Scholar 

  9. Zheng XY, ed. Guiding principles for clinical research on new drugs of traditional Chinese medicine. Beijing: China Medical Science Press; 2002:79–80.

  10. Bart BA, Goldsmith SR, Lee KL, Redfield MM, Felker GM, O’Connor CM, et al. Cardiorenal rescue study in acute decompensated heart failure: rationale and design of CARRESS-HF, for the Heart Failure Clinical Research Network. J Card Fail 2012;18:176–182.

    Article  Google Scholar 

  11. Kinugawa T, Ogino K, Kato M, Kato T, Osaki S, Endo A, et al. Altered purine and glycogen metabolism in skeletal muscle during exercise in patients with heart failure. Metabolism 1999;48:484–488.

    Article  CAS  Google Scholar 

  12. Bauer JA, Moffatt-Bruce SD, Elton TS, Feldman D. Purine metabolism in heart failure: oxidant biology and therapeutic indications. Congest Heart Fail 2008;14:283–284.

    Article  Google Scholar 

  13. Gao K, Zhao H, Gao J, Wen B, Jia C, Wang Z, et al. Mechanism of Chinese medicine herbs effects on chronic heart failure based on metabolic profiling. Front Pharmacol 2017;8:864.

    Article  Google Scholar 

  14. Yu Y, Yang S, Mao LG, Liu CM, Chen J, Hu YT, et al. Identification of potential metabolic biomarkers in yin deficiency syndrome using LC-MS. Anat Record 2020;303:2121–2130.

    Article  CAS  Google Scholar 

  15. Huang X, Chen Q, Yang G, Dai W, Lang Q, Du J, et al. Metabolic profiling study of yang deficiency syndrome in hepatocellular carcinoma by H1 NMR and pattern recognition. Evid-Based Compl Alt 2012;2012:1–6.

    Google Scholar 

  16. Lu X, Xiong Z, Li J, Zheng S, Huo T, Li F. Metabonomic study on ‘Kidney-yang deficiency syndrome’ and intervention effects of Rhizoma Drynariae extracts in rats using ultra performance liquid chromatography coupled with mass spectrometry. Talanta 2011;83:700–708.

    Article  CAS  Google Scholar 

  17. Tain YL, Hsu CN. Toxic dimethylarginines: asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). Toxins (Basel) 2017;9:92.

    Article  Google Scholar 

  18. Potočnjak I, Radulović B, Degoricija V, Trbušić M, Pregartner G, Berghold A, et al. Serum concentrations of asymmetric and symmetric dimethylarginine are associated with mortality in acute heart failure patients. Int J Cardiol 2018;261:109–113.

    Article  Google Scholar 

  19. Ruiz M, Labarthe F, Fortier A, Bouchard B, Thompson LJ, Bolduc V, et al. Circulating acylcarnitine profile in human heart failure: a surrogate of fatty acid metabolic dysregulation in mitochondria and beyond. Am J Physiol Heart Circ Physiol 2017;313:H768–H781.

    Article  CAS  Google Scholar 

  20. Ahmad T, Kelly JP, Mcgarrah RW, Hellkamp AS, Fiuzat M, Testani JM, et al. Prognostic implications of long-chain acylcarnitines in heart failure and reversibility with mechanical circulatory support. J Am Coll Cardiol 2016;67:291–299.

    Article  CAS  Google Scholar 

  21. Müller OJ, Heckmann MB, Ding L, Rapti K, Rangrez AY, Gerken T, et al. Comprehensive plasma and tissue profiling reveals systemic metabolic alterations in cardiac hypertrophy and failure. Cardiovasc Res 2019;115:1296–1305.

    Article  Google Scholar 

  22. Lopaschuk GD, Ussher JR. Evolving concepts of myocardial energy metabolism: more than just fats and carbohydrates. Circ Res 2016;119:1173–1176.

    Article  CAS  Google Scholar 

  23. Chen Y, Chen CX. Advances in energy metabolism in the pathogenesis and treatment of heart failure. Chin Tradit Patent Med (Chin) 2014;36:1272–1276.

    CAS  Google Scholar 

  24. Gan L, Jiang TT, Yi WJ, Lu R, Xu FY, Liu CM, et al. Study on potential biomarkers of energy metabolism-related to early-stage yin-deficiency-heat syndrome based on metabolomics and transcriptomics. Anat Record 2020;303:2109–2120.

    Article  CAS  Google Scholar 

  25. Stenemo M, Ganna A, Salihovic S, Nowak C, Sundström J, Giedraitis V, et al. The metabolites urobilin and sphingomyelin (30:1) are associated with incident heart failure in the general population. ESC Heart Failure 2019;6:764–773.

    Article  Google Scholar 

  26. Marcinkiewicz-Siemion M, Ciborowski M, Ptaszynska-Kopczynska K, Szpakowicz A, Lisowska A, Jasiewicz M, et al. LC-MS-based serum fingerprinting reveals significant dysregulation of phospholipids in chronic heart failure. J Pharm Biomed Anal 2018;154:354–363.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are grateful to all the participants and staffs in the trial.

Author information

Authors and Affiliations

  1. Graduate School of Beijing University of Chinese Medicine, Beijing, 100029, China

    Li-jun Guo & Yuan Zheng

  2. Cardiovascular Disease Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China

    Li-jun Guo, Ke-ji Chen, An-zhu Wang, Feng Gao & Xiao-chang Ma

  3. Institute of Basic Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China

    Ming-qian Sun

Authors
  1. Li-jun Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ke-ji Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ming-qian Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. An-zhu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Feng Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yuan Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xiao-chang Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Guo LJ and Sun MQ performed the entire experiment and wrote the manuscript. Ma XC contributed to the conceptualization and design of the experiment. Chen KJ made the comments on the experiments and manuscript. Gao F, Wang AZ, and Zheng Y contributed to the sample collection and experiment preparation.

Corresponding author

Correspondence to Xiao-chang Ma.

Additional information

Conflicts of Interest

The authors claim no potential conflicts of interest relevant to this article.

Supported by the National Natural Science Foundation of China (No. 81273932)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guo, Lj., Chen, Kj., Sun, Mq. et al. Metabonomics: A Useful Tool to Reveal Underlying Relationships between Altered Chinese Medicine Syndromes and Ultrafiltration in Treatment of Heart Failure. Chin. J. Integr. Med. 27, 259–264 (2021). https://doi.org/10.1007/s11655-020-3479-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11655-020-3479-7

Keywords

Search

Navigation