A new study published in the September 2023 issue of ESC Heart Failure reveals four proteins that could help indicate mortality in people who have pulmonary hypertension caused by left heart failure (LFH-PH). A research team out of Lund University in Sweden initiated the study following the 2021 European Society of Cardiology heart failure guidelines, which cited interest in finding novel biomarkers to aid in the outlook of this condition’s patient population.
Investigators examined the prognostic value of 20 plasma proteins related to tumor necrosis factor-alpha (TNF-a) in adult patients with LFH-PH. They discovered six proteins associated with TNF-a (a pro-inflammatory signaling molecule) that were noticeably higher in LHF-PH patients—four of which were statistically significant.
According to the published paper, results from the trial demonstrated that, “higher preoperative levels of LTBR, TNFRSF6B, TRAIL-R1 and TRAIL-R2 were associated with worse survival rates.” However, when the plasma levels of these four proteins were elevated in LFH-PH patients, they also frequently declined up to one year after a heart transplant surgery, “displaying a normalization pattern towards the levels of the healthy controls.”
Older age is also related to an increased risk of mortality, but patient sex and NT-proBNP levels are not. Upon adjusting the data for age and sex, all four proteins helped in predicting mortality for LHF-PH. In particular, TRAIL-R1 levels exhibited an increased mortality risk of 28%.
Early and accurate diagnosis of LHF-PH can be difficult due to the commonality of its primary symptoms, which are shared with many other heart and lung diseases. By identifying these blood-based biomarkers, clinicians could have better odds of detecting LHF-PH, as well as managing a patient’s progression and predicting a prognosis.
The research team concluded that additional large-scale studies are necessary to substantiate its findings and further explore the role of the TNF-a-related proteins in LHF-PH.
