Commun Med (Lond). 2026 Jan 21. doi: 10.1038/s43856-025-01353-0. Online ahead of print.
ABSTRACT
BACKGROUND: Ischemic heart disease is the leading cause of global mortality. Despite advances in clinical management, current diagnostic tools do not capture early metabolic disturbances associated with myocardial ischemia. Understanding these alterations may provide new insights into disease mechanisms.
METHODS: A metabolomic approach based on magnetic resonance spectroscopy is used to characterize the metabolic profile of patients with ischemic heart disease compared with non-ischemic individuals. Plasma and pericardial fluid collected during cardiac surgery are analyzed to investigate both systemic and heart-proximal molecular changes. Small-molecule concentrations are quantified and statistically evaluated to identify metabolic differences associated with ischemia.
RESULTS: Here we show that ischemic heart disease is associated with a distinct metabolic pattern. We observe increased concentrations of 3-hydroxybutyrate in both biological fluids, together with elevated succinate in pericardial fluid, indicating alterations in mitochondrial energy metabolism. Additional changes involve pathways linked to substrate utilization and redox balance.
CONCLUSIONS: These findings highlight a metabolic response to myocardial ischemia detectable in both systemic and locally collected fluids. The identified alterations offer a deeper understanding of the biochemical environment associated with ischemic heart disease.
PMID:41565779 | DOI:10.1038/s43856-025-01353-0