@Article{CHD.2020.012219,
AUTHOR = {Evan Pagano, Benjamin Frank, James Jaggers, Mark Twite, Tracy T. Urban, Jelena Klawitter, Jesse Davidson},
TITLE = {Alterations in Metabolites Associated with Hypoxemia in Neonates and Infants with Congenital Heart Disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {4},
PAGES = {251--265},
URL = {http://www.techscience.com/schd/v15n4/40120},
ISSN = {3071-1738},
ABSTRACT = {<b>Objectives:</b> (1) To measure the global shift in the metabolome in
hypoxemic versus non-hypoxemic infants with congenital heart disease; (2) To
identify metabolites and metabolic pathways that are altered in hypoxemia. <b>Study
Design:</b> Analysis of serum samples obtained prior to cardiopulmonary bypass
from 82 infants ≤120 days old with congenital heart disease requiring surgery
at Children’s Hospital Colorado. Infants were divided into groups based on preoperative oxygen saturations: non-hypoxemic (>92%), mild hypoxemia
(85–92%), and severe hypoxemia (<85%). Tandem mass spectrometry was used
to analyze 165 targeted metabolites. Partial least squares discriminant analysis and
t-tests were used to determine differences among metabolic profiles and individual
metabolites respectively. <b>Results:</b> The broad metabolic fingerprint of neonates or
older infants did not vary by degree of hypoxemia. There were 12 individual
metabolites that differed between hypoxemic and non-hypoxemic neonates,
including lower methylmalonic acid (<i>p</i> = 2.44 × 10<sup>–4</sup>
), glutamate (<i>p</i> = 0.001),
and hypoxanthine (<i>p</i> = 0.003), and higher thymine (<i>p</i> = 8.67 × 10<sup>–4</sup>
) and myo-inositol (<i>p</i> = 0.014) seen in hypoxemic neonates. Individual metabolites did not vary
significantly between older infants with or without hypoxemia. <b>Conclusions:</b> We
did not find evidence supporting global metabolic changes associated with cyanotic congenital heart disease in neonates or older infants. However, specific metabolites did discriminate between hypoxemic and non-hypoxemic neonates. These
include methylmalonic acid, as well as several metabolites known to change in
hypoxia-reoxygenation states (hypoxanthine) and chronic hypoxemic states
(glutamate, thymine, myo-inositol) and may represent specific metabolic changes
triggered by hypoxemia among neonates with cyanotic congenital heart disease.},
DOI = {10.32604/CHD.2020.012219}
}