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Use of biomarkers in the assessment of the early transition from arterial hypertension to heart failure

a biomarker and early transition technology, applied in the field of early transition from arterial hypertension to heart failure, can solve the problems of poor diagnostic capability, inability to diagnose individuals suffering from presymptomatic forms of hf, and major and growing public health problems

Inactive Publication Date: 2014-03-06
ROCHE DIAGNOSTICS OPERATIONS INC
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  • Summary
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  • Claims
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AI Technical Summary

Benefits of technology

The present disclosure provides a method for predicting the risk of heart failure in individuals with risk factors such as hypertension, diabetes, and diastolic dysfunction. The method involves measuring the concentrations of cardiac troponin markers in a sample from the individual and comparing them to a reference value. The method can also be used to diagnose early stages of heart failure and predict the risk of cardiovascular and renal events preceding heart failure. A device for carrying out the method is also provided. The use of multiple markers such as GDF-15 and IGFBP7 can further enhance the accuracy of the diagnosis and prediction.

Problems solved by technology

Heart failure (HF) is a major and growing public health problem.
Individuals suffering from presymptomatic forms of HF cannot be diagnosed by these established methods.
Poor diagnostic capabilities is one of the reasons that the survival rate for individuals diagnosed for HF is only 50% for 5 years.

Method used

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  • Use of biomarkers in the assessment of the early transition from arterial hypertension to heart failure
  • Use of biomarkers in the assessment of the early transition from arterial hypertension to heart failure
  • Use of biomarkers in the assessment of the early transition from arterial hypertension to heart failure

Examples

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example 1

[0520]Troponin T, NT-proBNP, GDF 15 and IGFBP7 were determined in the following collectives of individuals. An informed consent of the patients has been obtained.

[0521]Group 1: normotensive subjects, n=32.

[0522]Group 2: hypertensive subjects bearing risk factors of suffering from heart failure (stage A), n=47.

[0523]Group 3: hypertensive subjects with functional and / or structural abnormalities of the heart preceding heart failure, (early stage B); the subjects did not have elevated NT-proBNP levels the subjects showed structural changes to the left ventricle (increased septum wall thickness (>11 mm), increased posterial wall thickness (>12 mm), or first signs of either hypertrophy or concentric hypertrophy) and / or the subjects showed a systolic dysfunction (LVEF <50%) and / or diastolic dysfunction with preserved ejection fraction LVEF of at least 50%, n=37. The subjects did not suffer from left ventricular hypertrophy.

[0524]Group 4: subjects with dilated cardiomyopathy (DCM), n=29.

[05...

example 2

[0552]Troponin T, NT-proBNP and GDF-15 were determined in the below-described collective of individuals. A total of 97 patients with overt heart failure were included into the study, mean age 60.9 years, 52 males, 45 females, LVEF below 50%, who had a normal kidney function as documented by normal creatinine levels. All patients were on beta blocker as well as on ACE inhibitor therapy, 59 patients were on aldosterone antagonists, 38 did not receive aldosterone antagonists. Patients were treated in the study according to guidelines (see above). None of the patients suffered from diabetes mellitus or metabolic syndrome, in addition none of the patients suffered from liver disease or malignancies.

[0553]38 patients receiving no aldosterone (all Class C) had the following characteristics:

TABLE 11Marker concentrations in 38 patients receiving no aldosterone.ratioNT-proNT-proratioBNPTroponin TGDF-15LVEFNYHABNP / GDFTroponinPercentile(pg / mL)(pg / mL)(pg / mL)(%)class15T / GDF 15251571.7663571.00.19...

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Abstract

Methods and systems for diagnosing functional and / or structural abnormalities of the heart preceding heart failure, and for predicting the risk of developing heart failure, in a subject comprising measuring a cardiac troponin in a sample and comparing the measurement to a reference value. Other markers, including GDF15 and IGFBP7 are also measured in some embodiments.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of International Application No. PCT / EP2011 / 063398, filed Aug. 3, 2011 which claims the benefit of European Patent Application No. 10174182.5, filed Aug. 26, 2010, and European Patent Application No. 10186710.9, filed Oct. 6, 2010, the disclosures of which are hereby incorporated by reference in their entirety.BACKGROUND OF THE DISCLOSURE[0002]An aim of modern medicine is to provide personalized or individualized treatment regimens. Those are treatment regimens which take into account a patient's individual needs or risks. Personalized or individual treatment regimens may even be taken into account for measures where it is required to decide on potential treatment regimens.[0003]Heart failure (HF) is a major and growing public health problem. It is estimated that approximately 5 million patients in the USA have HF, more than 500 000 patients are diagnosed with HF for the first time each year, and more th...

Claims

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Application Information

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IPC IPC(8): G01N33/68
CPCG01N33/6893G01N33/6887G01N2800/52G01N2800/50G01N2800/325G01N2333/4712G01N2333/495G01N2333/58G01N33/54306
Inventor WIENHUES-THELEN, URSULA-HENRIKEBLOCK, DIRKHEUDIG, HENDRIKVOGEL-ZIEBOLZ, SABINEBOEHM, CHRISTINEHESS, GEORGHORSCH, ANDREAZDUNEK, DIETMAR
Owner ROCHE DIAGNOSTICS OPERATIONS INC
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