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Cleveland Clinic Research Uses Breath Test to Identify Heart Failure in Patients

Non-invasive Test Detects Leading Cause of Hospital Readmissions

March 25, 2013

Cleveland Clinic researchers have successfully identified heart failure in patients by using exhaled breath analysis, a newly published study in the Journal of the American College of Cardiology shows.

The study’s results revealed that a non-invasive test based on patients’ unique breathprints is able to distinguish between those with heart failure from those without heart failure. The findings provide a new avenue to understanding heart failure and better identification of individuals who may be at risk for hospital readmission due to heart failure.

Hospital readmission rates are under increased scrutiny, as Medicare payments will be cut for healthcare systems with higher-than-expected readmission rates for certain diagnoses, including heart failure. Recent data shows that the 30-day readmission rate after heart failure hospitalization was 24.8 percent across the United States; 61 percent of those cases were readmitted within 15 days of hospitalization (JAMA, Jan. 2013).

Detecting heart failure through exhaled breath relies on analysis of hundreds of volatile organic compounds (VOCs). Using technology from previous research to identify VOCs that correlate with the presence of cardiovascular disease, a team of investigators conducted a prospective, single-center study to assess whether exhaled breath analysis can identify patients admitted to the hospital with acute decompensated heart failure (ADHF).

“While additional examination is needed to determine the true potential of breath analysis for heart failure identification in our patients, we’re very encouraged by these results,” said Raed Dweik, MD, a pulmonologist in the Respiratory Institute at Cleveland Clinic, and lead investigator for the study. “The ability to identify patients with heart failure using a breath test has the potential for broad application due to its non-invasive nature and ease of application.  These exciting new observations may lead to future studies to determine how to best utilize these information to reduce heart failure re-hospitalizations.”

A team approach using expertise in both cardiovascular and pulmonary disease was imperative for this study’s success. Wilson Tang, MD, a cardiologist and research director for heart failure in the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic, applied specialized knowledge in cardiac medicine, which allowed a comprehensive understanding of the study’s outcomes.

The study included 61 patients. Of those, 25 patients were admitted with heart failure as a primary diagnosis, 16 control subjects with non-heart failure cardiovascular categorization. An additional 36 subjects were used to validate the positive research findings.

Cleveland Clinic’s Respiratory Institute, ranked #3 in the nation by U.S.News & World Report, is a leader in breath testing research, and has had previous success in detecting and identifying unique breathprints for lung cancer, asthma, and cardiovascular and pulmonary disease.  Currently, additional research is being conducted to determine the presence of liver disease and the body’s compliance with diet.

This research is supported by Ohio Third Frontier, a Ohio Department of Development commitment to create new technology-based products, companies, industries and jobs throughout Ohio, and the National Institute of Health under grant numbers R01HL10391, P20HL113452, HL107147, HL081064, HL103453, HL109250, and RR026231.

For additional information on respiratory research and innovation at Cleveland Clinic, please visit

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Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. About 2,800 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. Cleveland Clinic Health System includes a main campus near downtown Cleveland, eight community hospitals and 18 Family Health Centers in Northeast Ohio, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and, currently under construction, Cleveland Clinic Abu Dhabi. In 2010, there were 4 million visits throughout the Cleveland Clinic health system and 167,000 hospital admissions. Patients came for treatment from every state and from more than 100 countries. Visit us at  Follow us at

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