Heart failure Metabolomics: NMR studies

National Heart, Lung, And Blood Institute

Investigators

Linked publications & trials

Abstract

We continued our investigations into the prognostic value of the novel NMR Metabolic Vulnerability Index (MVX) in heart failure. MVX is calculated using indicators of systemic inflammation (small HDL particles, GlycA) and metabolic malnutrition (leucine, valine, isoleucine, citrate). We have previously demonstrated the prognostic value of MVX predicting mortality risk in a HF community cohort. The goal of this study was evaluating the distribution of MVX and its clinical correlates within a clinical trial population and a comparable subpopulation of patients with heart failure with reduced ejection fraction and ischemic heart disease within a community cohort. We examined MVX measurements collected from a clinical trial (2016-2018) and a community cohort (2003-2012), matched based on ejection fraction category and presence of ischemic heart failure. Univariable and multivariable regression models were used to assess the relationship between MVX (modeled continuously), and selected demographic and clinical covariates. We found the median MVX score was lower in the clinical trial (50, 42-61) compared to the cohort (66, 58-73). Male sex and hyperlipidemia were linked to higher MVX scores in the clinical trial, while obesity and NT-proBNP were linked to lower and higher MVX scores, respectively, in the cohort (p <.05). After adjusting for significant covariates from univariable analyses and age in multivariable analyses, only the associations between male sex and MVX scores in the clinical trial, and NT-proBNP levels with MVX in the cohort remained significant. This study highlights significant differences in MVX distribution and its clinical correlates between a clinical trial and a community cohort despite matched heart failure subtypes. These findings have important implications for interpreting and applying the score in diverse study settings.