Assessment of novel biomarkers in patients with heart failure and associated co-morbidities
In chronic heart failure (CHF), an injured or overloaded heart struggles to pump sufficient blood around the body to maintain normal function of organs and tissues. It affects approximately 80,000 New Zealanders, and is one of our leading causes of death. When the heart is under increased stress, it releases more of the heart protein B-type natriuretic peptide (BNP) into the blood. BNP is produced from a parent protein called proBNP, which is then ‘chopped’ into two main products, BNP and NT-proBNP, with the latter generally being an excellent marker for the detection and follow-up of heart failure (HF). However, in those who are obese, have irregular heart rhythm (atrial fibrillation; AF), are diabetic, very old or have reduced kidney function, the test is less accurate. Therefore, we aim to investigate three novel BNP variants (proBNP, NG-T71, BNP1-32) in obese and/or diabetic people and those with AF who are 1) without HF and 2) with acute or chronic HF. This work will determine whether our markers can improve on the utility of NT-proBNP for detecting HF or forecasting outcomes in these patients, and identify whether these markers can complement or replace NT-proBNP in important HF subgroups, facilitating more personalised care.
Dr Appleby is a Research Fellow in the Translational Biodiscovery Laboratory of the Christchurch Heart Institute. The major focus of my research is based on a recently discovered peptide myoregulin which is encoded from what was previously classified as long non-coding RNA. Myoregulin is thought to regulate calcium by inhibiting the intracellular calcium pump and therefore may be a crucial regulator of heart function.