Quick and reliable diagnostics are the key to controlling many diseases, including cardiovascular disease. Biomarkers are a big player in next-generation diagnostics, replacing the old and often invasive testing from days past.
Biomarkers represent one of the biggest advances in diagnostics in the past several decades. Research has been able to link certain compounds, metabolites, and proteins (aka biomarkers) to diseases. Some biomarkers can even give a good idea as to a patient’s prognosis. B-type natriuretic peptide (BNP) has become a staple for the diagnosis and prognosis of heart failure for cardiovascular disease. However, one good biomarker isn’t enough to generate the powerful tests of the future.
In a new study out of Jikei University School of Medicine in Tokyo, a team investigated whether metabolites might act as promising biomarkers. Metabolites are molecules involved in metabolism (i.e., energy production) in the cell. Cellular metabolism often shifts a little depending on the state of the cell, and the metabolites can change depending on which state a cell is in.
Previous studies have revealed ketosis, a metabolic pathway used when there isn’t a lot of sugar around, might be upregulated during heart failure. Specifically, a metabolite called ketone bodies seemed to be elevated in patients with failing hearts in a way that might even be able to predict the severity of heart failure as well. This study looked at whether total blood ketone bodies correlated with BNP and other cardiac indicators used for cardiac problems.
The study gathered data from over a thousand cardiovascular patients who had been admitted to the university’s hospital over a three-year time span. The team collected the patients’ medical history, as well as blood samples and other heart data at the time of admittance. They saw total blood ketone body levels correlated well with levels of other cardiac biomarkers such as BNP. They also negatively correlated with things like left ventricle ejection, a measure of how much blood the heart is actually pumping. All of this pointed to blood ketone bodies as a good candidate as a cardiac biomarker, but it wouldn’t serve as an independent biomarker.
This study identified that ketone levels did indeed correlate directly with B-type natriuretic peptide, regardless of other variables. While this doesn’t make total blood ketone levels a full-fledged biomarker just yet, further study may reveal it to be useful.
The study concludes, “…in patients with cardiovascular disorders, the blood TKB levels were positively increased along with the BNP levels, but not the hemodynamic indices, such as the LVEDP, LVESVI, and LVEDVI. Taken together the results of the present findings suggest that the NP secreted from the failing heart might activate the utilization of ketone bodies as an alternative fuel to fatty acid and glucose in the failing heart.”