METHOD FOR PHENOTYPING CHRONIC HEART FAILURE BASED ON METABOLOMIC PROFILING Russian patent published in 2025 - IPC G01N33/68 G01N33/82 G01N33/92 G01N30/72 A61B5/29 A61B8/06 

FIELD: medical science.

SUBSTANCE: group of inventions refers to medicine, namely to cardiology, and may be used for four-phenotype chronic cardiac failure phenotype determination: phenotype of chronic heart failure with stored ejection fraction, metabolic phenotype, ischemic cardiomyopathy phenotype, phenotype of severe decompensated chronic heart failure by two methods. Blood is sampled in patients with chronic heart failure. In the first method, quantitative chromatographic-mass-spectrometric analysis is used to determine the concentration of circulating metabolites in blood plasma: acylcarnitines: C5-OH, C6-DC, C14, C12, C18-1, C6, C5-DC, C5-1, C8-1, C10, C16-1, C16, C14-2, C12-1; metabolites of the tryptophan-kynurenine pathway: quinolonic acid, xanthuric acid, 3-OH-anthranilic acid, tryptophan; and tryptophan-serotonin pathway: 5-methyltryptamine, 5-hydroxytryptophan; glutamine-glutamate cycle metabolites: glutamine, glutamate; serine amino acids; vitamin riboflavin; methionine sulfoxide and the neurotransmitter norepinephrine. Methods of machine learning determine phenotype of patients with chronic heart failure, in accordance with coefficients of 26 metabolites presented in table 4 of description. Principal component method is used to first reduce the dimension of the data to nine principal components and then hierarchical cluster analysis is performed, wherein the distance between clusters is determined using a Ward method. According to the second method, blood plasma is examined for the concentration of N-terminal fragment of natriuretic peptide (NT-proBNP). Echocardiography is performed, echocardiography parameters are determined: final systolic size of left ventricle, final diastolic size of left ventricle, final systolic volume of left ventricle, final diastolic volume of left ventricle, emission fraction, left ventricular wall relative thickness index, right atrium volume. Each of four phenotype values M1-M4 is calculated by declared formulas. Indicators M1, M2, M3 and M4 are compared. Value with the highest percentage is selected. If M1 is the highest, the phenotype of chronic heart failure with preserved ejection fraction is stated. Highest M2 shows the metabolic phenotype. Highest M3 shows the phenotype of ischemic cardiomyopathy. Greatest M4 shows the phenotype of severe decompensated chronic heart failure.

EFFECT: methods provide an opportunity to increase the accuracy of determining the phenotype of chronic heart failure from the four declared phenotypes by distributing patients with chronic heart failure into phenogroups by means of biostatistical processing of the results of the quantitative determination of 26 recovered blood plasma metabolites, as well as determining the concentration of NT-proBNP in the blood and echocardiography parameters.

2 cl, 3 dwg, 11 tbl, 4 ex