About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

New Way to Predict the Prognosis for Heart Failure Patients Discovered

by Sheela Philomena on December 15, 2013 at 11:18 AM
Font : A-A+

 New Way to Predict the Prognosis for Heart Failure Patients Discovered

A novel way to predict which heart failure patients are likely to see their condition get worse and which ones have a better prognosis has been identified by Johns Hopkins researchers.

About half of the 5 million people suffering from heart failure in the United States have non-ischemic cardiomyopathy, which means that their heart failure is not due to blocked arteries.

Advertisement

"It is difficult to predict which people with non-ischemic heart failure will do poorly and be at a higher risk of death," says Robert Weiss, M.D., a cardiologist and professor of medicine at the Johns Hopkins University School of Medicine and senior author of the study. "Having a more precise way to determine a patient's risk would enable us to identify high-risk people earlier and tailor their treatments more specifically. And with a new target — impaired energy metabolism — we can also open the door to developing and testing new therapies for heart failure," he says.

In their study, described online on Dec. 11 in Science Translational Medicine, the researchers measured energy metabolism in the hearts of 58 patients using magnetic resonance spectroscopy. The patients were then followed for a median of 4.7 years to track heart failure hospitalization, heart transplantation, the placement of a ventricular assist device and/or death from all causes.
Advertisement

Specifically, the researchers examined how the energy that fuels heart muscle cells, known as adenosine triphosphate (ATP), reacted with the enzyme creatine kinase (CK). The role of CK is to maintain a constant energy supply in the beating heart. The researchers were able to measure the rate of ATP synthesis through the CK reaction within patients' heart cells noninvasively with magnetic resonance spectroscopy, a type of imaging that detects metabolism, or energy use, in organs and tissues without using contrast agents or ionizing radiation.

"We found that the rate of energy metabolism in heart muscle was significantly lower in those heart failure patients whose conditions got worse and needed hospitalization, implantation of a ventricular assist device or a heart transplant, or had died from their weakened heart," says co-lead author Paul Bottomley, Ph.D., professor and director of the Division of Magnetic Resonance Research at the Johns Hopkins University School of Medicine. "We believe that the rate of ATP delivery to the cells by CK can be used along with established methods to better predict heart failure events and improve the timing of intensive interventions for patients."

Established methods include the New York Heart Association (NYHA) Functional Classification system that places patients in one of four categories based on how much they are limited during physical activity, with symptoms that include shortness of breath and chest pain. The ejection fraction, which shows how well the heart can pump blood to the rest of the body, is also used as a prediction method. African-Americans are also in a higher risk category.

"The current methods used for prediction are not reflective of the underlying mechanism in the weak heart, and some of them are not very consistent in their predictive ability. That's why there's a need for new methods that could potentially be more specific," says co-lead author Gurusher Panjrath, M.D., who performed the work while at Johns Hopkins and is now an assistant professor of medicine and director of the Heart Failure and Mechanical Support Program at the George Washington School of Medicine & Health Sciences in Washington, D.C.

The researchers say that even after correction for NYHA class, ejection fraction and race, reduced energy metabolism was a significant predictor of heart failure outcomes in their study.

"It makes sense that failing hearts with reduced energy supply are at increased risk of adverse outcomes, because the heart requires a lot of chemical energy to beat and function normally," says Weiss. "Now that our study has shown that energy metabolism in the human heart can be measured with an MRI scanner to predict heart failure outcomes, future studies are needed to determine the factors that impair energy metabolism in heart failure."

The researchers say this imaging method to measure energy metabolism could now be used in combination with other determinants of risk to provide a more complete picture of heart failure prognosis, helping doctors better plan the course of treatment for their patients.

According to the Centers for Disease Control, heart failure costs the nation an estimated $32 billion each year, including the cost of health care services, medications to treat heart failure and missed days of work. About half of the people who develop heart failure die within five years of diagnosis. The cause of non-ischemic heart failure, which is not due to blockages in coronary arteries and heart attack, is often unknown, but it can include high blood pressure, diabetes, infections and certain inherited conditions.

Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
News Category
What's New on Medindia
First-Ever Successful Pig-To-Human Kidney Transplantation
World Osteoporosis Day 2021 -
Spirituality and Mental Health
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Congenital Heart Disease Heart Healthy Heart Pulmonary Arterial Hypertension Statins Mitral Valve Prolapse Aortic Valve Stenosis Infective Endocarditis Cough Symptom Evaluation Pericarditis 

Recommended Reading
Congestive Heart Failure
Congestive heart failure (CHF) is a condition in which the heart fails to work adequately as a pump ...
Quiz on Heart
The heart is a fist-sized organ that never ceases to pump blood during its lifetime. The efficiency ...
Early Diagnosis & Effective Treatment of Heart Failure in Children
Heart failure in children is an important cause of childhood health problems and death....
Aortic Valve Stenosis
Aortic valve Stenosis is an abnormal narrowing of the c valve. Symptoms include angina, and that of ...
Congenital Heart Disease
Heart diseases that are present at birth are called “ Congenital heart diseases”....
Cough Symptom Evaluation
Cough is a symptom of a condition usually affecting the respiratory tract. It may be acute or chroni...
Infective Endocarditis
Infective endocarditis has been arbitrarily categorized as acute or subacute based on the length of ...
Mitral Valve Prolapse
Mitral Valve Prolapse is a relatively common condition and causes leakage of blood through the valve...
Pericarditis
Pericarditis occurs when the pericardium gets inflamed. Pericarditis is characterized by severe ches...
Pulmonary Arterial Hypertension
It can be a serious condition affecting the heart. It is defined as mean pulmonary arterial pressure...
Statins
Statins are new wonder drugs that are proving to be efficacious, not merely in relieving symptoms bu...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use