ASSESSING METABOLIC CHANGES IN ATHLETES WITH ISCHEMIC HEART FAILURE AND CHRONIC KIDNEY DISEASE USING ULTRA PERFORMANCE LIQUID CHROMATOGRAPHY-HIGH RESOLUTION MASS SPECTROMETRY (UPLC-HRMS)

Abstract

Objective: To explore the implications of ischemic heart failure (HF) and its progression to chronic kidney disease (CKD) in athletic individuals through advanced metabolomic profiling. Methods: This study examined systolic HF from ischemic origins and CKD resulting from ischemic HF in athletes. Participants included 32 patients with ischemic HF, 15 with HF-induced CKD, and 47 healthy athletic controls, all assessed between January 2017 and April 2018. Plasma samples were analyzed using ultra-high performance liquid chromatography–high resolution mass spectrometry (UPLC-HRMS), with data processed through Partial Least Squares-Discriminant Analysis (PLS-DA) to identify distinctive metabolic biomarkers. Results: Metabolic profiling revealed 78 distinct endogenous metabolites. The PLS-DA models effectively differentiated between HF and control groups, as well as HF and HF-CKD groups. Key biomarkers identified included LysoPC (18:2), choline, valine, indole, 3-indoleacrylic acid, and p-cresyl sulfate for HF; and LysoPC (18:3), γ-caprolactone, ketovaleric acid_1, and ketovaleric acid_2 for HF-CKD. These biomarkers linked primarily to disrupted lipid and amino acid metabolism pathways. Conclusion: Metabolomic profiling via UPLC-HRMS has uncovered critical metabolic shifts and biomarkers in athletes with ischemic HF and HF-related CKD, highlighting the potential for targeted management strategies to mitigate the progression of these conditions in sports medicine.