By analyzing patients' "breathprint", i.e. a single puff of exhaled air, researchers at the Cleveland Clinic have managed to quickly determine whether they have heart failure. They published their findings in the Journal of the American College of Cardiology.
The authors pointed out that their prospective study was based on a small group of participants (61 patients). More extensive research is needed to confirm their initial promising results.
If larger trials confirm their findings, this could be a new avenue to understanding heart failure and better identify people who might be at greater risk of hospital readmission due to heart failure.
US hospitals are currently being scrutinized carefully by Medicare regarding their readmission rates for certain diagnoses, including heart failure. Those with higher-than-expected readmission rates face having their Medicare payments cut.
According to recent data, nearly one quarter (24.8%) of heart failure patients who are hospitalized in the USA are readmitted within 30 days of being discharged; 61% of them are readmitted within 15 days.
To be able to detect heart failure by analyzing exhaled breath, hundreds of VOCs (volatile organic compounds) have to be analyzed. The team used previous research to identify VOCs that are associated with cardiovascular disease. They carried out a prospective, single-center study to determine whether exhaled breath analysis can identify those who were hospitalized with ADHF (acute decompensated heart failure).
Lead-investigator, Raed Dweik, MD, a pulmonologist in the Respiratory Institute at Cleveland Clinic, said:
"While additional examination is needed to determine the true potential of breath analysis for heart failure identification in our patients, we're very encouraged by these results. The ability to identify patients with heart failure using a breath test has the potential for broad application due to its non-invasive nature and ease of application.
These exciting new observations may lead to future studies to determine how to best utilize these information to reduce heart failure re-hospitalizations."
Acetone and Pentane Levels Higher Among Heart Failure PatientsOf the sixty-one patients involved in the study, 25 had been hospitalized with heart failure as a primary diagnosis, 16 were healthy "controls", and another 36 people were added to validate the positive research findings.
The authors reported that they were able to correctly diagnose heart failure in all the patients who had been hospitalized with the disease. The breath test not only identified all the patients with heart failure, but also clearly distinguished them from cardiac cases without heart failure.
The exhaled breath of patients with heart failure had considerably higher levels of organic compounds acetone and pentane, compared to those without heart failure.
Dr. Dweik explained that a person's breath may reveal a great deal about their health, apart from their heart failure status.
Diagnosing heart failure in the emergency departmentWhen doctors in an emergency department are faced with a patient with shortness of breath and a risk of heart failure, they usually reach out for their stethoscope.
The stethoscope allows them to hear the abnormal third sound in the heart's rhythm - known as S3 - which is strongly linked to cardiac disease and heart failure. However, it has a low-pitch sound which is notoriously hard to hear with a stethoscope alone.
Researchers at the University of Cincinnati found that acoustic cardiography, which combines a 12-lead ECG with cardiac acoustic data, can significantly help physicians in detecting the S3.
In 2010, this was seen as an important advance in heart failure diagnosis. The Cleveland Clinics' latest simple breath test, which has so far been 100% accurate, would help doctors even more.
What is heart failure?Heart failure is a serious medical condition in which the heart cannot pump blood throughout the body efficiently. Either the left or right side of the body may be affected, and sometimes both.
Symptoms depend on which side of the body is affected and how severe the heart failure is.
The number of elderly patients admitted to hospital with heart failure in the USA has more than doubled over the last three decades. Experts say this is partly due to an aging population, and that more patients survive heart attacks and heart disease today.
Lay people sometimes confuse heart failure with heart attack or cardiac arrest. Below is a brief explanation of the three terms:
- Heart failure - the heart cannot pump blood properly, efficiently around the body. It is not a heart attack.
- Heart attack - consists of the death of heart muscle due to a blockage (occlusion) of a coronary artery. Heart muscle dies because it is not getting enough oxygen-rich blood.
- Cardiac arrest - the heart stops pumping.