Metabolomics in Cardiovascular Diseases: Biomarkers Quest

Abstract

Cardiovascular Diseases (CVD) remain the leading cause of death and reduced life expectancy worldwide according to the 2010 reports of the Global Burden of Disease [1,2]. CVDs affect all age groups, and the number of affected individuals is becoming more alarming, thus the importance of defining early diagnostic biomarkers, that can be helpful to detect and possibly prevent the occurrence of cardiovascular diseases and associated accidents, is of utmost importance. Ultimately these biomarkers could help establishing a personalized regimen for the treatment of a given patient and open the way for a novel drug design strategy. Several biomarker discovery approaches have been incorporated into the field of CVD, but of recent interest is the application of metabolomics approach. The metabolome is defined as the total complement of low-molecular-weight metabolites in a biological system under a set of environmental conditions [3,4]. These metabolites can be the direct result of the individual's genome; thus, forming the primary metabolome or can include the byproducts of the metabolism of commensal bacteria living in the body forming the secondary metabolome. Both primary and secondary metabolomes are being investigated in the quest of biomarker discovery for CVD [4]. Metabolomics application on serum samples has been of increasing interest in CVD given that heart tissue is not available for investigation as with malignancy, for instance. The serum study of metabolites can provide a min-to-min profile of the metabolic changes that can help detect the adaptive " metabolic shift " that cardiomycoytes undergo in several CVD. This shift is reflected by changes in terms of metabolite utilization and modification. These changes could be an early sign of the perturbations associated with CVD. Studying metabolic profiles in CVD is of increasing interest given that metabolites are the " proximal receptors " of disease phenotypes [5]. Similar to other biomarker deciphering disciplines, metabolomics aims at discovering prognostic and diagnostic biomarkers of CVD. These would be used for better risk assessment, early detection of the disease and limiting the use of invasive expensive and time-consuming procedures such as angiography, and finally monitoring disease progression and response to treatment [6]. As these biomarkers are predicted to be central hubs in the systems' metabolic network, they would also provide an insight into the pathogenesis of these diseases.