A blood test could help identify those at highest risk of dying from heart failure within the next five years, new Oxford University research conducted in collaboration with an Indian-origin professor has found.
The study, funded by the British Heart Foundation (BHF) and published in the ‘European Journal of Heart Failure’ this week, was led by Neil Herring, Professor of Cardiovascular Medicine and Consultant Cardiologist at the University of Oxford, in collaboration with Professor Pardeep Jhund at the University of Glasgow.
The researchers suggest that measuring a protein called neuropeptide Y (NPY) alongside hormone B-Type Natriuretic Peptide (BNP) could help diagnose heart failure patients, pinpointing those who may be at higher risk of dying. “Patients with heart failure are still at a high risk of dying despite the advances in treatment,” said Professor Jhund. “Our work shows that NPY is a promising marker that can be measured in the blood to determine which patients are more likely to die. We hope that this will allow us to identify patients who may benefit from new therapies,” he said.
Heart failure occurs when the heart can’t pump blood around the body as well as it should. It is a life-limiting condition resulting in frequent hospital visits and reduced quality of life and there is currently no cure. NPY is released by nerves in the heart in response to extreme stress. It can trigger potentially dangerous heart rhythms and causes constriction of the smallest blood vessels in the heart muscle, making the heart work harder and causes blood vessels going to the heart to contract.
Data from over 800 participants at different stages of heart failure were used and participants were measured 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. Researchers adjusted for known factors that can influence how heart failure progresses, including age, kidney function, how well the heart pumps and BNP levels. Patients with high levels of NPY, who made up about a third of the study participants, had 50 per cent higher risk of dying over the three-year follow up period from a heart complication compared to those with lower levels.
Professor Herring said: “The findings of this research are an exciting new development, building on over 10 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 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 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 be resulting in out-of-hospital cardiac arrests. “This new research suggests that a new, cheap and simple blood test, could help us in future to more accurately spot which patients with heart failure are at highest risk of early death,” explained Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation.
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 said. Identifying those at greatest risk early on could also help healthcare professionals decide the best course of treatment for their patients, helping spot those who may benefit from having a potentially lifesaving ICD fitted. The team hopes that a blood test for NPY could be used in clinics within five years.
Next, the researchers hope to carry out larger trials using data from patients with very high levels of NPY, to see whether it can accurately identify those who may benefit from having a potentially lifesaving ICD. Further research will also explore whether NPY could in future be used as a chemical for drugs to target and bring further benefit to heart patients drug target. It is currently estimated that over 1 million people living with heart failure in the UK, and around new 200,000 diagnoses in the UK each year.
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