The researchers hope to validate a blood test that can detect abnormal early changes in blood flow in the arteries of the heart during an effort. This is a test based on 5 metabolites.
The electrocardiogram (ECG) signless chest pain may correspond to an early stage of infarction ... or not: in the absence of ECG signs, coronary angiography can not be systematically investigated. In the near future, a simple blood test could indicate whether the arteries carrying blood in the heart are narrowed or occluded, which would better determine whether the patient should benefit from catheterization imaging of his arteries.
In people who arrive at the emergency department for chest pain, those who have decreased blood flow in the coronary arteries during a stress test (on a treadmill) would also have a modification of five metabolites circulating in their blood. . It appears in less than two hours. This is apparent from a study of 40 people published in the journal PLOS ONE.
A study on the metabolome
Previous studies have suggested that the analysis of metabolites in the blood may be indicative of heart disease related to decreased blood supply to the heart from clogged coronary arteries. But researchers had yet to discover the specific "metabolomic signature" in the blood for this phenomenon.
In the Duke University study, scientists evaluated the presence of more than 60 chemicals or compounds in the blood (metabolites) to identify the five specific metabolites that seemed to change in coronary patients whose stress tests on exercise were abnormal. All patients in the study had come to the emergency department with symptoms of coronary heart disease, such as chest, jaw and shoulder pain.
A simple test to guide explorations
The metabolome consists of all small molecules, metabolites (sugars, amino acids, fatty acids ...) that can be found in a biological sample such as blood.
These promising results still require a broader study to confirm that the acute changes in effort of these five metabolites (fatty acids and amino acids), energy sources for the heart cells, could constitute an early biological indicator of alteration. of blood flow in the coronary arteries. This would make it possible to determine whether patients really need "coronarography" imaging, a more invasive test (raising a probe from the puncture of a peripheral artery), more risky and more expensive.
Improving the performance of a stress test to determine the need for coronary artery imaging is a major challenge for cardiologists dealing with ECG-free chest pain. This test based on a simple blood test would be able to reveal precisely when the heart begins to suffer during a simple effort and would represent a major advance to better indicate a coronarography.