Biomarkers can forecast the development of incident heart failure

Finnish researchers have discovered biomarkers that are associated with incident heart failure. The study looked at 10,106 men participating in the Metabolic Syndrome in Men (METSIM) study, who at baseline did not have a diagnosis of incident heart failure. These biomarkers included adiponectin, high-sensitivity C-reactive protein, the chronic inflammation biomarker GlycA, the amino acids alanine and phenylalanine, as well as glycerol and pyruvate, which the heart muscle uses for energy. After adjustment for age, body mass index, diabetes and statin medication, adiponectin, pyruvate and urinary albumin excretion rate were associated with the development of incident heart failure. "Incident heart failure is typically associated with changes in heart metabolism as well as with low-grade, chronic inflammation. Based on our study, these changes are present even years before any sign of heart failure," Johanna Kuusisto, a cardiologist and internist from the University of Eastern Finland, said. Further research could help ascertain whether drugs targeting inflammatory and metabolic pathways could be used to prevent the development of incident heart failure. Their findings appeared Dec. 5, 2020, in ESC Heart Failure.

Mouse model helps researchers find MAARS lncRNA

Researchers are examining how atherosclerosis occurs and progresses by looking at long noncoding RNAs (lncRNAs), strands of RNA that are not translated into proteins and could play roles in cell regulation and disease progression. Using genetically modified, high-risk atherosclerotic mice, Brigham and Women's Hospital scientists identified and characterized Macrophage-Associated Atherosclerosis lncRNA Sequence (MAARS), which is expressed specifically in macrophages in atherosclerotic plaques and contributes to the progression of the disease. Mark Feinberg, senior author and a member of the Brigham's Division of Cardiovascular Medicine, and colleagues used genetically modified mice prone to atherosclerosis and placed them on a high cholesterol diet. The mice were on high-cholesterol diets for 12 weeks, then placed on a normal diet and observed while their cholesterol levels returned to normal. They isolated the innermost lining of the animals’ blood vessel walls and sent the samples for RNA sequencing to identify the presence of lncRNAs. "lncRNAs play a really important role in cardiovascular disease," said Feinberg. "We had no idea what we were going to find, and we ended up identifying a lncRNA that has a crucial role in macrophages and pathways that could have therapeutic potential. We are shedding light on new players in old signaling pathways. It is so exciting to add more nuance to this area of research, since that means future studies will have that much more to work with." Results were published Dec. 1, 2020, in Nature Communications.

Heart disease deaths rise in age of COVID-19

University College London (UCL) researchers have determined that lower rates of hospital attendance for heart problems at the start of the COVID-19 pandemic may have contributed to avoidable deaths in England. That is because people avoided trips to the emergency department, a phenomenon also seen in the U.S. The UCL researchers saw their findings published online Dec. 20, 2020, in the journal Circulation cardiovascular quality and outcomes. The team used mortality counts from the Office of National Statistics for England and calculated the change in daily emergency department visits via data from the Public Health England Emergency Department Syndromic Surveillance System. To explore how the reduction in emergency department visits may have affected cardiac mortality, they turned to causal inference methodology. "During the initial phase of the pandemic, between March 12 and April 15, 2020, there was an estimated fewer ED [emergency department] visits of 2,750 per week for suspected cardiac disease; this is around a 35% decrease compared to the pre-pandemic period this year,” lead author Michail Katsoulis, of the UCL Institute of Health Informatics, said. He added that one cardiac death possibly could have been prevented or delayed for every additional 12 emergency department visits for suspected cardiac conditions. “We estimated that the excess cardiac mortality due to non-attendance at EDs, during the initial phase of the pandemic, may have been as high as 232 deaths per week."