PMID- 34727537
OWN - NLM
STAT- MEDLINE
DCOM- 20220310
LR  - 20220311
IS  - 1752-7163 (Electronic)
IS  - 1752-7155 (Linking)
VI  - 16
IP  - 1
DP  - 2021 Nov 16
TI  - Breath acetone concentration: too heterogeneous to constitute a diagnosis or 
      prognosis biomarker in heart failure? A systematic review and meta-analysis.
LID - 10.1088/1752-7163/ac356d [doi]
AB  - Introduction. Exhaled breath acetone (ExA) has been investigated as a biomarker 
      for heart failure (HF). Yet, barriers to its use in the clinical field have not 
      been identified. The aim of this systematic review and meta-analysis was to 
      assess the ExA heterogeneity and factors of variability in healthy controls (HC), 
      to identify its relations with HF diagnosis and prognostic factors and to assess 
      its diagnosis and prognosis accuracy in HF patients.Methods. A systematic search 
      was conducted in PUBMED and Web of Science database. All studies with HC and HF 
      patients with a measured ExA were included and studies providing ExA's diagnosis 
      and prognosis accuracy were identified.Results. Out of 971 identified studies, 18 
      studies involving 833 HC and 1009 HF patients were included in the meta-analysis. 
      In HC, ExA showed an important heterogeneity (I(2)= 99%). Variability factors 
      were fasting state, sampling type and analytical method. The mean ExA was 1.89 
      times higher in HF patients vs. HC (782 [531-1032] vs. 413 [347-478] ppbv;p< 
      0.001). One study showed excellent diagnosis accuracy, and one showed a good 
      prognosis value. ExA correlated with New York Heart Association (NYHA) dyspnea 
      (p< 0.001) and plasma brain natriuretic peptide (p< 0.001). Studies showed a poor 
      definition and reporting of included subjects.Discussion. Despite the 
      between-study heterogeneity in HC, the evidence of an excellent diagnosis and 
      prognosis value of ExA in HF from single studies can be extended to clinical 
      populations worldwide. Factors of variability (ExA procedure and breath sampling) 
      could further improve the diagnosis and prognosis values of this biomarker in HF 
      patients.
CI  - (c) 2021 IOP Publishing Ltd.
FAU - Gouzi, Fares
AU  - Gouzi F
AUID- ORCID: 0000-0001-8970-866X
AD  - PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France.
FAU - Ayache, Diba
AU  - Ayache D
AD  - IES, Montpellier University, CNRS, F-34000 Montpellier, France.
FAU - Hedon, Christophe
AU  - Hedon C
AUID- ORCID: 0000-0001-9505-2097
AD  - PhyMedExp, University of Montpellier, INSERM, CNRS, CHRU, Montpellier, France.
FAU - Molinari, Nicolas
AU  - Molinari N
AD  - IDESP, INSERM, Montpellier University, Montpellier University Hospital, 
      Montpellier, France.
FAU - Vicet, Aurore
AU  - Vicet A
AD  - IES, Montpellier University, CNRS, F-34000 Montpellier, France.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20211116
PL  - England
TA  - J Breath Res
JT  - Journal of breath research
JID - 101463871
RN  - 0 (Biomarkers)
RN  - 1364PS73AF (Acetone)
SB  - IM
MH  - *Acetone
MH  - Biomarkers
MH  - Breath Tests/methods
MH  - *Heart Failure/diagnosis
MH  - Humans
MH  - Prognosis
OTO - NOTNLM
OT  - acetone
OT  - biomarker
OT  - exhaled breath
OT  - heart failure
OT  - pulmonary function test
EDAT- 2021/11/03 06:00
MHDA- 2022/03/11 06:00
CRDT- 2021/11/02 20:04
PHST- 2021/03/15 00:00 [received]
PHST- 2021/11/02 00:00 [accepted]
PHST- 2021/11/03 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/11/02 20:04 [entrez]
AID - 10.1088/1752-7163/ac356d [doi]
PST - epublish
SO  - J Breath Res. 2021 Nov 16;16(1). doi: 10.1088/1752-7163/ac356d.