P92 Metabolomics in children with heart failure using ACE-inhibitors, an exciting opportunity?

IntroductionACE inhibitors (ACEi) have a prominent place in the treatment of heart failure in children. However, there is a significant interpatient variability in efficacy and safety in those children that is not completely understood. Metabolomics provides an interesting innovative approach to better understand underlying mechanisms for variation in disease and response to therapy. With this review, we aim to provide an overview of metabolomics in the field of heart failure therapy with or without ACEi in both adults and children and try to identify gaps in this field.MethodsThe PubMed database was systematically searched using several search strategies. Articles were labelled as relevant when they included information on either metabolomics of adult patients with heart failure and/or ACEi-therapy or in children. This yielded 42 relevant articlesResults24 articles were found describing metabolomics in adults with heart failure, either with or without ACEi-therapy. In addition, several metabolites were identified in adults correlating with either ACEi-efficacy or safety. No metabolomics articles were found in children with heart failure or in children on ACEi-therapy. Several papers (18) were found on metabolomics in children for other diseases and/or treatments.ConclusionMetabolomics in adult heart failure patients has helped to unravel part of observed disease and therapy variability, and appears helpful in identifying patients at risk for therapy failure as well as detecting novel targets for heart failure therapy. In children, a significant information gap exists. This provides exciting opportunities for personalized treatment of heart failure.Disclosure(s)This work was partially supported by LENA, a Collaborative Project funded by the European Union under the 7th Framework Programme under grant agreement n° 602295.