Nazima Pathan
University of Cambridge, UK
Title: Metabolic profiling of children undergoing surgery for congenital heart disease
Biography
Biography: Nazima Pathan
Abstract
Inflammation and metabolism are closely interlinked. Both undergo significant dysregulation following surgery for congenital heart disease, contributing to organ failure and morbidity. We examined changes in key inflammatory and metabolic markers following congenital heart surgery, to examine the potential of metabolic profiling for stratifying patients in terms of expected clinical outcomes. Metabolic profiling of blood plasma was undertaken using proton nuclear magnetic resonance (NMR) spectroscopy. A panel of metabolites was measured using a curve-fitting algorithm. Inflammatory cytokines were measured by ELISA. The data were assessed with respect to clinical markers of disease severity (RACHS-1, PELOD, inotrope score, duration of ventilation and PICU-free days).
Changes in metabolic and inflammatory profiles were seen over the time course from surgery through to recovery, compared to the pre-operative state. Tight glycemic control did not significantly alter the response profile. We identified a panel of metabolites associated with surgical and disease severity. The strength of proinflammatory response, particularly IL-8 and IL-6 concentrations, inversely correlated with PICU free days at 28 days. This is the first report on the metabolic response to cardiac surgery in children. Using NMR to monitor the patient journey we identified metabolites whose concentrations and trajectory appeared to be associated with clinical outcome. Metabolic profiling could be useful for patient stratification and directing investigations of clinical interventions.