Cardiologist Chiadi Ndumele discusses the current strategies used to prevent heart failure and the research being conducted as part of the Heart Failure Prevention Program at Johns Hopkins.
Yeah, we know some things about the prevention of heart failure, but there's still much that we have to learn. There's some evidence that certain medications, like ACE inhibitors, may prevent the progression to heart failure among individuals with asymptomatic cardiac dysfunction. We've also found important associations between physical activity and heart failure risk. We found that engaging in recommended levels of physical activity is associated with lower heart failure risk both in the overall population and among subgroups that are classified as high risk for future heart failure development. In addition, in our work, we found that among individuals who are not initially engaging in recommended physical activity, transitioning to engaging in recommended physical activity is associated with lower heart failure risk. This speaks to the idea that both maintaining and initiating physical activity, even in midlife and among individuals at high risk, is a promising strategy for lowering heart failure risk in the population. Mhm. There is quite a bit of exciting work going on at the cutting edge of heart failure prevention. Our group is very interested in refining our understanding of the pathways leading to heart failure risk that allows us to develop enhanced strategies for both prediction and prevention of heart failure. One area that we're focused on is the protein biomarkers, both within the circulation and in tissues like within fat cells that actually relate directly to heart failure risk. One of the groups of proteins that were interested in are called Aditya kinds, which are proteins secreted by fat cells and their surrounding inflammatory cells that appear to mediate many of the metabolic actions related to obesity. This is an area of intense research. Focus for our group. In addition, we're very focused on cardiac biomarkers, which show us when they're elevated within the bloodstream. Very subtle and subclinical levels of cardiac injury, fibrosis and structural change that precede the development of clinical heart failure. We've related many of these cardiac biomarker elevations to many of the metabolic risk factors we focus on, like obesity, diabetes and metabolic syndrome. And we're quite interested in understanding the links between these metabolic risk factors and cardiac biomarkers, as well as the modify ability of those cardiac biomarkers that could further change heart failure risk. We're interested, additionally, in using novel imaging techniques that help us to better understand the subtle structural changes that occur within the heart before true heart failure onset develops. In addition, we're looking at some of the novel therapies that are out there currently, including the STL T two inhibitors, which are agents that have now been shown to lower heart failure, risk and various populations. But the mechanisms were not well understood. Understanding the mechanisms is a part of our current work within heart failure prevention as well. So our group is focused on using these various technologies at the cutting edge of heart failure prevention research to both refine our strategies for heart failure prevention and to apply them to clinical populations where we can have the greatest clinical impact.