Unbiased Heterojunction Design for Aqueous Humor Metabolic Monitoring of Cardiovascular Complications in Marfan Syndrome.

Cardiovascular complications represent the most life-threatening manifestations of Marfan syndrome (MFS). However, reliable and well-tolerated monitoring strategies for these complications remain an unmet clinical need. In this study, a bimetallic oxide heterostructure is designed featuring petal-shaped nanostructures and nanoneedle protrusions, which integrates the complementary affinities of the constituent oxides with lowered ionization barriers, enabling unbiased detection across the full polarity spectrum of metabolites. With enhanced spectral acquisition capabilities and interpretable machine learning algorithms, aqueous humor samples collected from ophthalmic examinations of MFS patients are analyzed, a necessity given that eye problems are among the initial symptoms of MFS. This achieves effective monitoring of the onset of cardiovascular complications in MFS patients, with a mean AUC of 0.946, an accuracy of 0.891, and a precision of 0.893. Moreover, as two subtypes of cardiovascular complications in MFS, organic lesions and valve regurgitation are also accurately differentiated by the method, with AUC, accuracy, and precision values of 1.00. This work offers novel insights into the early diagnosis and management of MFS cardiovascular complications, contributing to aqueous humor-based metabolic analysis, molecular diagnostics, and precision medicine.