Heart failure with preserved ejection fraction (HFpEF) is a complex condition that often develops in people with multiple other health problems, and is believed to arise from a network of related systemic processes. While existing protein biomarkers for HFpEF exhibit diagnostic limitations, a comprehensive protein analysis approach, known as proteomics, has the potential to improve diagnosis and disease characterization. A recent Circulation: Heart Failure study explored whether distinct groups of circulating proteins in patients from the VITALITY-HFpEF trial correlated with clinical characteristics and functional status at baseline and follow-up.
Researchers analyzed 368 cardiovascular and inflammation-related proteins in prerandomization blood samples from 763 VITALITY-HFpEF participants, all of whom had left ejection fraction of 45% or higher and a heart failure decompensation within 6 months. They identified four separate protein clusters, each associated with distinct biological pathways.
Study findings revealed that proteins linked to circulatory inflammation and apoptosis (programmed cell death) are associated with clinical indicators of frailty and poor functional status in HFpEF patients, as shown by both qualitative and quantitative assessments. Notably, the researchers also identified a counterbalancing protein cluster linked to a mitigating effect on HFpEF morbidity and declining functional capacity over time. Further investigation and validation of a more comprehensive protein portfolio could facilitate a refined phenotyping approach for HFpEF patients, and potentially yield a more detailed understanding of baseline pathophysiology and improved treatment and prognostic strategies.
This research was conducted on behalf of the VITALITY-HFpEF Study Group and led by Christopher deFilippi, MD and supported by Christopher O’Connor, MD, both from the Inova Heart and Vascular Institute, where the proteomic measurements were performed. CVC co-authors include Wendim Alemayehu, PhD, Cindy Westerhout, PhD, and Paul Armstrong, MD.
