3-Heptanone as a potential new marker for valproic acid therapy

Breath gas samples from 27 patients with epilepsy (17 male and 10 female patients; mean age: 9.7 years, median age: 8.2 years, SD: +/- 4.2 years) were screened via proton transfer reaction mass spectrometry. The patients were treated with valproic acid (VPA) therapy, and blood samples for determination of VPA concentrations were surveyed. All patients showed significantly elevated concentrations of 3-heptanone (C(7)H(14)O) in exhaled breath gas (mean: 14.7 ppb, median: 13.8 ppb SD: +/- 5.7 ppb). In human breath, several hundred different volatile organic compounds can be detected. In breath of patients with valproic acid monotherapy, an increased concentration of 3-heptanone was measured. The objective of this study was to investigate if serum VPA concentrations correlate with 3-heptanone concentrations in exhaled breath. In conclusion, 3-heptanone in breath gas is significantly elevated in patients treated with the valproic acid, but does not correlate significantly with the VPA concentrations in serum or the daily dose of this drug.