New markers for sick hearts

Two new markers have been discovered for the type of heart failure whereby the heart muscle becomes stiff and unable to fill the heart with blood properly. ‘Estimating the gravity of the stiff type of heart failure is difficult with the regular markers’, explains cardiologist Dirk Lok. ‘But now it has become possible. The new NT-proCNP marker appears to have good predictive values for this condition. Another new marker, Galectin-3, does not only predict this type of heart failure, but also another more recognizable type whereby the heart muscle weakens.’ Lok, a cardiologist in Deventer Hospital, conducted his research in collaboration with the Cardiology Department of the UMCG. He will be awarded a PhD by the University of Groningen on 22 May 2013.

There are two types of heart failure. In the most well-known type, the heart muscle weakens and the pump action becomes ineffective. The other type of heart failure involves a stiffening of the heart muscle, which prevents the heart from filling with blood properly. In both cases, blood is not pumped around the body efficiently, causing patients to develop symptoms such as fatigue, shortness of breath, swollen legs and ankles, restless nights and frequent night-time urination. A total number of 150,000 patients in The Netherlands is affected by heart failure and both types occur in the same number of people. Patients suffering from heart failure due to a stiff heart muscle are mostly female, older, have hypertension, diabetes and are overweight. The prognosis is sombre.

Patients

‘Diagnosing heart failure due to a stiff heart muscle is difficult using the regular methods, particularly for GPs’ says Lok. ‘As a result, a large number of people are going through life undiagnosed, despite showing the classic symptoms. The techniques currently used do not always detect heart problems. The new markers will make it much easier to diagnose heart failure.’ Lok measured the values of the Galectin-3 and NT-proCNP markers in large groups of patients with heart failure. He discovered that it was easier to estimate the risk of complications in patients with heart failure due to a stiff heart muscle using both markers than when using the regular marker used up until now.

Better care

‘Measuring markers in the blood to clarify the diagnosis heart failure and predict the progress of the disease has improved patient care considerably over the past few years’, according to Lok. At present, drug treatment is chosen according to the amount by which the marker levels have risen. ‘The introduction of these new markers means that we are ready for the next step: diagnosing the disease at an early stage and providing prompt and targeted treatment. This may lead to fewer hospital admissions for heart failure and possibly a lower mortality rate’, claims Lok.

Curriculum Vitae

Dirk Lok (Groningen, 1953) studied Medicine at the University of Groningen and has worked as a cardiologist in Deventer Hospital since 1984. He conducted his research under the supervision of Prof. D.J. van Veldhuisen and Dr P. van der Meer in a partnership between the Cardiology Department of the University Medical Center Groningen (UMCG) and the cardiology research department of Deventer Hospital. Lok’s thesis is entitled ‘Novel markers in chronic heart failure.’