New Test May Improve Heart Failure Treatment

Researchers in a study have recently created new tests that may improve heart failure diagnosis and treatment. These tests can also detect the onset of congestive heart failure earlier than ever before, according to a study published by Clinical Chemistry.

Heart failure is a condition that results from the heart not pumping blood adequately due to damage caused by numerous factors, such as coronary artery disease, diabetes, or even drug abuse. It is one of the leading causes of death in the United States.

Currently, blood tests that diagnose heart failure detect B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Unfortunately, these tests tend to produce inaccurate results, and are not able to detect early and asymptomatic disease, according to the authors.

In the study, the investigators developed a new diagnostic panel that assesses biological molecules, which show a more extensive representation of heart function.

The investigators identified 92 metabolites that were altered in patients with heart failure, of which they chose 3 for their lipid panel that are part of the sphingomyelin, triglyceride, and phosphatidylcholine classes.

In a confirmation trial, the researchers tested the ability of their cardiac lipid panel plus NT-proBNP measurements to diagnose 649 individuals who were healthy, had heart failure, or had pulmonary disease.

The results from this study indicated the novel cardiac lipid panel plus NT-proBNP was able to diagnose heart failure more accurately compared with the NT-proBNP test alone. The combination test had a specificity of 97.6%, while the NT-proBNP test alone had a specificity of 88.1%, according to the study.

The novel test also demonstrated the ability to diagnose patients with early and asymptomatic disease, which no other test can reliably do.

In some patients, heart failure can progress to congestive heart failure, which is characterized by fluid build-up in the limbs, lungs, and other organs as a result of the heart’s decreased function. Systemic congestion is a major factor of organ dysfunction and death in these patients.

There is currently no test that can diagnose pre-symptomatic congestion, however, this is needed so patients can be diagnosed and treated early to prevent disease progression. This new combination test may be able to diagnose patients with heart failure early on, and prevent poor patient outcomes, including progression to congestive heart failure, according to the study.

"A low false-positive rate is particularly important in the outpatient setting and may prevent patients from unnecessary diagnostic workup and treatment, which in turn will save resources and avoid potential side-effects," said lead researcher Hugo A. Katus, MD, PhD. "A more accurate diagnosis of patients with early and intermediate […] and mild or asymptomatic systolic dysfunction as observed with the novel panel compared to NT-proBNP alone may accelerate adequate pharmacological or behavioral treatments for the reduction of mortality and morbidity in these patients."