Researchers at Johns Hopkins have shown that genetic testing can be effectively used to distinguish between heart failure patients who suffer from ischemic or nonischemic forms of the disease. Using groupings or clusters of a patients gene expression to compare to a diseased "test" set that identifies the cause of heart failure, the Hopkins team assembled a 90-gene profile to determine which type of heart failure had most likely developed. Results showed the test profile to be highly accurate, with 90 percent specificity.
The findings could, if affirmed and adapted to a standardized and affordable test format, someday aid physicians in the diagnosis of heart failure and help determine which kind of therapy is best to use for the condition. In ischemic heart disease, the patients arteries have narrowed and the heart cannot pump normally because blood flow (and thus oxygen) is often restricted to the heart muscle. In nonischemic forms of the disease, the heart cannot pump normally because the heart muscle has often enlarged for other reasons, such as physical deformity or alcohol abuse. Both conditions can lead to cardiac arrest or more gradual heart failure as the muscle weakens over time.
"The gene expression differences between various forms of cardiovascular disease are poorly understood, despite the fact that we know there are major differences in what is happening at the cellular level," said Michelle Kittleson, M.D., cardiology fellow at the Johns Hopkins Heart Institute and lead author of the study to be presented at the American Heart Associations Scientific Sessions 2004 on Nov. 6, as a finalist for the Samuel A. Levine Young Clinical Investigator Award. "Our study shows that gene expression profiling for heart failure patients is not only possible, but accurate as well. Based on these initial findings, we hope to close the gaps in our understanding of the gene expression patterns underlying heart failure and treatments for the illness. Ultimately, we hope to be able to use genetic profiling to classify patients according to their risk of developing all kinds of heart disease."
David March | EurekAlert!
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