A blood test could help identify patients who are most likely to die of heart failure within the next five years, according to new Oxford University research undertaken in partnership with an Indian-origin professor. Neil Herring, Professor of Cardiovascular Medicine and Consultant Cardiologist at the University of Oxford, led the study, which was funded by the British Heart Foundation (BHF) and published this week in the ‘European Journal of Heart Failure’. Professor Pardeep Jhund of the University of Glasgow also contributed.
The researchers propose that monitoring a protein known as neuropeptide Y (NPY) in conjunction with the hormone B-type natriuretic Peptide (BNP) could aid in the diagnosis of heart failure patients, identifying those who are more likely to die. “Patients with heart failure are still at a high risk of dying despite the advances in treatment,” stated Dr. Jhund. “Our findings suggest that NPY is a promising marker that can be detected in the blood to predict which patients are most likely to die. “We hope that this will help us identify patients who could benefit from new therapies,” he said.
Heart failure happens when the heart cannot pump blood throughout the body as effectively as it could
Heart failure happens when the heart cannot pump blood throughout the body as effectively as it could. It is a life-limiting condition that causes frequent hospital visits and a lower quality of life, and there is presently no solution. Nerves in the heart emit NPY in reaction to acute stress. It can induce potentially harmful heart rhythms and constriction of the tiniest blood vessels in the heart muscle, which causes the heart to work harder and blood vessels leading to the heart to contract. Data from over 800 participants at different stages of heart failure were used and subjects were examined for levels of the hormone B-type natriuretic Peptide (BNP), a hormone currently used to diagnose heart failure. Participants’ blood pressure and echocardiograms—a type of ultrasound heart scan – were also taken and were followed up regularly.
The researchers controlled for known characteristics that can influence how heart failure advances, such as age, renal function, how effectively the heart pumps, and BNP levels. Patients with high levels of NPY, which accounted for around one-third of the trial participants, had a 50% higher chance of dying from a heart problem over a three-year follow-up period than those with lower levels. Professor Herring stated, “The findings of this study are an exciting new development, building on over ten years of collaborative research on this stress hormone.”
“We hope our research will ultimately benefit the increasing number of patients who are living with the debilitating effects of heart failure daily. Next, we will investigate whether measuring for very high levels of neuropeptide Y could influence whether patients can get lifesaving treatment like ICDs [implantable cardioverter defibrillators] before the blood test can be rolled out within five years.”
Participants who had high NPY levels were not admitted to the hospital any more frequently during the study than other groups. Researchers suggest that this could be because NPY may be linked to abnormal heart rhythms, which could result in out-of-hospital cardiac arrests. “This new research suggests that a new, cheap, and simple blood test, could help us in the future to more accurately spot which patients with heart failure are at the highest risk of early death,” explained Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation.
The researchers intend to conduct larger trials utilizing data from patients with very high levels of NPY
“Measuring neuropeptide Y levels could in future offer healthcare professionals greater insights into how a patient’s heart failure is likely to progress, in particular, whether those with high levels of neuropeptide Y would benefit from additional treatment to reduce their higher risk,” he added. Identifying those at greatest risk early on could also assist healthcare practitioners in determining the best course of treatment for their patients, including identifying those who may benefit from having a potentially lifesaving ICD implanted. The team believes that a blood test for NPY will be available in clinics within five years.
The researchers intend to conduct larger trials utilizing data from patients with very high levels of NPY, to determine if it can reliably identify those who may benefit from having a potentially lifesaving ICD. Further research will also explore whether NPY could, in the future be used as a chemical for drugs to target and bring further benefit to heart patients. It is currently estimated that over 1 million people living with heart failure in the UK, and around 200,000 are diagnosed in the UK each year.
