In-hospital metabolite changes in infective endocarditis—a longitudinal 1H NMR-based study

Research output: Contribution to journalArticle


Treatment of infective endocarditis (IE) is a 4–6-week provided course of intravenously administered antibiotics. The aim of this study was to investigate how serum metabolites as measured by proton nuclear magnetic resonance (1H NMR) spectroscopy are changing over time during the active phase of IE, and to see whether these metabolite changes might be used to monitor recovery in these patients. Patients hospitalized with first-time IE at Herlev Hospital, Denmark, from September 2015 to June 2017 were included. Longitudinal blood sampling was performed and serum was analyzed using 1H NMR. Orthogonal projection to latent structures discriminant analysis (OPLS-DA) was used to separate sample groups and analyze differences in metabolite profiles. Thirteen patients were included in the study (77% men, median age 62 years (IQR 53–77)). All patients were cured during the hospitalization without any relapse during 6 months of follow-up. We analyzed 61 serum samples (median 5 samples, range 2–8 per person) drawn in the treatment period after IE diagnosis. The main changes during the in-hospital period were decreased levels of glucose, mannose, leucine, isoleucine, phenylalanine, tyrosine, and signals from polyols and N-acetylated protein. The metabolomic changes could in contrast to the routinely used parameters CRP and leucocyte levels distinguish between the early and late stages of disease treatment. We present the first longitudinal study of 1H NMR metabolomics in patients with infective endocarditis. The metabolomic changes show a promising strength compared to routinely used clinical parameters.


  • Christine Falk Klein
  • Sarah Louise Kjølhede Holle
  • Malene Højgaard Andersen
  • Anders Pedersen
  • Henning Bundgaard
  • Kasper Karmark Iversen
  • Anders Malmendal
External organisations
  • Gentofte Hospital
  • University of Gothenburg
  • Copenhagen University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Infectious Medicine


  • Antibiotic treatment, Infective endocarditis, Longitudinal study, Metabolomics, NMR
Original languageEnglish
Pages (from-to)1553–1560
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Issue number8
Early online date2019 May 22
Publication statusPublished - 2019
Publication categoryResearch