A Peripheral Blood Transcriptome Biomarker Test to Diagnose Functional Recovery Potential in Advanced Heart Failure

Abstract

Heart failure (HF) is a complex clinical syndrome that causes systemic hypoperfusion and failure to meet the body's metabolic demands. In an attempt to compensate, chronic upregulation of the sympathetic nervous system and renin-angiotensin-aldosterone leads to further myocardial injury, HF progression and reduced O 2 delivery. This triggers progressive organ dysfunction, immune system activation and profound metabolic derangements, creating a milieu similar to other chronic systemic diseases and presenting as advanced HF with severely limited prognosis. We hypothesize that 1-year survival in advanced HF is linked to functional recovery potential (FRP), a novel clinical composite parameter that includes HF severity, secondary organ dysfunction, co-morbidities, frailty, disabilities as well as chronological age and that can be diagnosed by a molecular biomarker.

Short-Term Therapies for Treatment of Acute and Advanced Heart Failure—Why so Few Drugs Available in Clinical Use, Why Even Fewer in the Pipeline?

“…Beyond these thoughts is the much more significant challenge of sifting this unprecedented mass of data to identify signs, signals and biomarkers that are robust, reliable, meaningful and capable of being used to guide therapy. The work Deng and colleagues, who have advocated for pre-procedural gene expression profiles of peripheral blood mononuclear cells as indicative of longer-term survival prospects in patients with AdHF undergoing mechanical circulatory support, is an illustration of the immense and exciting potential in this area [51,52]. We are unreservedly positive for the longer-term prospects in this area but once more concur with the views of Sim [49] and others, about the challenges of successful implementation [53,54,55].…”

Comparing NGS and NanoString platforms in peripheral blood mononuclear cell transcriptome profiling for advanced heart failure biomarker development

“…Now, we aim to create a clinical test that predicts 1-year survival status of individual AdHF patients before any type of HF surgical/interventional therapy, such as mechanical circulatory support surgery or heart transplantation [15][16][17]. Our HF-survival prediction development strategy consists of a candidate gene discovery phase, followed by a lockdown of a gene list on a clinical-commercial platform.…”

Welcome to the 13Th Volume of Biomarkers in Medicine

“…Our most read perspective in 2018 is titled 'A peripheral blood transcriptome biomarker test to diagnose functional recovery potential in advanced heart failure' and authored by MC Deng, University of California (CA, USA) [4]. The work discusses the use of leukocytes as a predictive biomarker to diagnose functional recovery potential for advanced heart failure patients pretreatment.…”