Targeted metabolomic analysis of serum phospholipid and acylcarnitine in the adult Fontan patient with a dominant left ventricle
The Fontan procedure is a surgical technique established in the 1970’s indicated for children who were born with a single functional ventricle, which can lead to a series of cardiac conditions. The procedure consists in diverting parts of the venous blood arriving at the heart towards the pulmonary arteries in order to reduce ventricular workload. Following this surgery, many patients are able to enjoy a normal quality of life which includes normal development and the ability to tolerate exercise.
In this study by Michel et al., young adults who underwent the Fontan procedure as children (univentricular group) were compared to healthy controls (biventricular group) to investigate the long-term effects of the procedure on their metabolome.
While cardiac function was comparable between the two groups, lipidomics performed on serum samples demonstrated that the univentricular patients had higher acylcarnitines levels than the biventricular controls. In addition, the levels of phosphatidylcholines and sphingomyelins were reduced in univentricular patients compared to controls, while lyso-phosphatidylcholines levels seemed to be unaffected.
The authors concluded on the potential of targeted metabolomics and lipidomics to identify biomarker patterns to provide new diagnostic strategies with minimally intensive follow-up procedures for Cardiac patients. This could extend to conditions such as heart failure in biventricular patients, certain types of inflammation, and alterations of the lymphatic or endothelial systems.
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Miriam Michel, Karl-Otto Dubowy, Manuela Zlamy, Daniela Karall, Mark Gordian Adam, Andreas Entenmann, Markus Andreas Keller, Jakob Koch, Irena Odri Komazec, Ralf Geiger, Christina Salvador, Christian Niederwanger, Udo Müller, Sabine Scholl-Bürgi and Kai Thorsten Laser: Targeted metabolomic analysis of serum phospholipid and acylcarnitine in the adult Fontan patient with a dominant left ventricle. Therapeutic Advances in Chronic Diseases. 2020. https://doi.org/10.1177/2040622320916031