|Description||Background: Heart failure (HF) prevalence is increasing in the United States.
Mechanical Circulatory Support (MCS) therapy is an option for Advanced HF
(AdHF) patients. Perioperatively, multiorgan dysfunction (MOD) is linked to the
effects of device implantation, augmented by preexisting HF. Early recognition of
MOD allows for better diagnosis, treatment, and risk prediction. Gene expression
profiling (GEP) was used to evaluate clinical phenotypes of peripheral blood
mononuclear cells (PBMC) transcriptomes obtained from patients’ blood samples.
Whole blood (WB) samples are clinically more feasible, but their performance in
comparison to PBMC samples has not been determined.
Methods: We collected blood samples from 31 HF patients (57¡15 years old)
undergoing cardiothoracic surgery and 7 healthy age-matched controls, between
2010 and 2011, at a single institution. WB and PBMC samples were collected at a
single timepoint postoperatively (median day 8 postoperatively) (25–75% IQR 7–14
days) and subjected to Illumina single color Human BeadChip HT12 v4 whole
genome expression array analysis. The Sequential Organ Failure Assessment
(SOFA) score was used to characterize the severity of MOD into low (# 4 points),
intermediate (5–11), and high ($ 12) risk categories correlating with GEP.
Results: Results indicate that the direction of change in GEP of individuals with
MOD as compared to controls is similar when determined from PBMC versus WB.
The main enriched terms by Gene Ontology (GO) analysis included those involved
in the inflammatory response, apoptosis, and other stress response related
pathways. The data revealed 35 significant GO categories and 26 pathways
overlapping between PBMC and WB. Additionally, class prediction using machine
learning tools demonstrated that the subset of significant genes shared by PBMC
and WB are sufficient to train as a predictor separating the SOFA groups.
Conclusion: GEP analysis of WB has the potential to become a clinical tool for
immune-monitoring in patients with MOD||en_US