Analysis of serum phospholipid profiles by liquid chromatography-tandem mass spectrometry in high resolution mode for evaluation of atherosclerotic patients.

Atherosclerosis is one of the most frequent etiology for myocardial infarction and death. It is also the main cause of angina pectoris, a perceived symptom that results of a mismatch between myocardial supply and demand, caused by the partial obstruction of the arteries. The correct diagnosis of atherosclerosis can led to a reduction of mortality. In this research, the phospholipids profile of serum samples from patients diagnosed with stable angina and non-ST elevation myocardial infarction (NSTEMI) or unstable angina was obtained by selective solid-phase extraction (SPE) and subsequent LC-QTOF MS/MS analysis in high resolution mode. Comparative statistical analysis allowed finding four potential markers to discriminate between stable angina and NSTEMI/unstable angina: lysoPC(20:5), PC(18:1/18:2), PC(18:0/20:4) and SM(d18:2/14:0). The panel generated by multivariate ROC analysis by combination of the four compounds provided a disease prediction capability in the training set of 70.7 and 66.0% for stable angina and NSTEMI patients, respectively. On the other hand, external validation by application to an independent cohort improved the predictive power for angina stable patients (92.3%), while this was slightly decreased up to 50.0% for NSTEMI/unstable angina patients. In this way, LC-QTOF MS/MS has shown to be a useful strategy for phospholipid profiling in serum and development of tools to aid in clinical diagnostic.

Method based on GC-MS to study the influence of tricarboxylic acid cycle metabolites on cardiovascular risk factors.

Metabolites involved in the tricarboxylic acid (TCA) cycle have previously been proposed as cardiovascular biomarkers. This cycle plays a key role in cell metabolism and the levels of the involved metabolites can also be affected by other physiological factors. The influence of three cardiovascular risk factors such as obesity, hypercholesterolemia, and smoking habit on serum levels of TCA-cycle metabolites has been studied in patients diagnosed with significant coronary lesion. For this purpose, a method based on GC-MS for determination of the target metabolites (viz. citric/isocitric, pyruvic, aconitic, oxaloacetic, malic, fumaric and succinic acids) in serum has been developed. The high accuracy and throughput analysis featuring the method have allowed application to a cohort of 223 patients, 172 of them with significant coronary lesion. Multifactor analysis of variance has revealed interactions between the occurrence or not of a coronary lesion and the risk factors considered in this study. These interactions were crucial to explain the levels of target TCA metabolites. Statistical evaluation by ROC curves allowed discrimination of the capability of significant metabolites with the occurrence of coronary lesions.

Determination of essential amino acids in human serum by a targeting method based on automated SPE-LC-MS/MS: discrimination between artherosclerotic patients.

An automated method based on a hyphenated SPE-LC-MS/MS configuration has been optimized for the determination of essential amino acids (threonine, valine, methionine, leucine, isoleucine, lysine, tryptophan, and phenylalanine) in human serum, with the aim of discriminating between different states of coronary artery disease. Validation in terms of sensitivity (detection limits below 28.0 ng on column) and precision (repeatability expressed as relative standard deviation below 6.0%) supports the suitability of the method for application to a cohort of 122 atherosclerosis patients confirmed by a catheterization test. The cohort was composed by 80 individuals diagnosed with stable angina and 42 patients who suffered from acute myocardial infarction (AMI). Both groups of individuals are differentiated by the occurrence of ischemia in AMI patients due to the formation of thrombi. The chemometric treatment of the data obtained by multivariate analysis of variance (MANOVA) allowed comparison between both groups of diagnosed patients. Therefore, amino acids whose serum levels were affected by ischemia have been identified. The contribution of risk factors such as obesity and hypercholesterolemia as well as the individuals' gender to the concentration of essential amino acids has also been studied.

[Peripartum cardiomyopathy with biventricular thrombi]. / Miocardiopatía periparto con trombosis biventricular.

Peripartum cardiomyopathy is a rare cause of congestive heart failure which develops in the last month of pregnancy or during five months postpartum in women without previously known cardiac disease. Intraventricular thrombi are no unusual and can be identified by echocardiography. We report the case of a woman with peripartum cardiomyopathy whose echocardiographic study showed the presence of biventricular thrombi. This is a quite rare finding with only two cases reported in the literature. Diagnosis, treatment and special situations that could predispose to intracardiac thrombi formation are discussed.

[Clinical presentation, diagnosis and treatment of four cases of cor triatriatum]. / Presentación clínica, diagnóstico y tratamiento de cuatro casos de cor triatriatum.

We report four cases of cor triatriatum. In two of them the fibromuscular membrane was obstructive and associated with an atrial septal defect between the left atrial accessory chamber and the right atrium; in those cases the clinical findings were due to the pulmonary hypervascularity. The third case was associated to a small patent foramen ovale, and the clinical findings were due to the obstruction to flow through the membrane in the left atrium, producing venocapilar pulmonary hypertension. In these three cases surgical treatment was carried out through a right atriotomy. In all of them a good corelationship was found between the echocardiographic and the surgical findings. The follow-up has been good, all previous symptoms disappearing, remaining symptom free. The fourth case is an asymptomatic 5-year-old girl, with a non-obstructive membrane and without any associated anomalies.