Advancing Diagnostic Biomarkers for Cardiovascular Disease

James Januzzi, MD, is the director of the Dennis and Marilyn Barry Fellowship in Cardiology Research, and the Hutter Family Professor of Medicine at Harvard. In this video, he discusses his team’s focus on the role of biomarker testing to diagnose the presence of cardiovascular disease and to establish prognosis or course of the disease.

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Transcript

So much of our work at the Massachusetts General Hospital Heart Center focuses on the role of biomarker testing in a number of different places. One is to diagnose the presence of cardiovascular disease, but another is to establish prognosis or course of the disease. So, for diagnosis, a single measurement is usually useful but in order to better understand the prognosis of patients with different types of heart disease, it's important to measure these biomarkers that reveal different pathophysiology in heart failure over a period of time. And serial measurements usually tell us more than a single measurement when it comes to understanding how the patient's prognosis may be changing and how they may respond to therapy. And that's really the main reason we measure biomarkers, after all, is to better understand our patients.

We at Massachusetts General Hospital Heart Center have been leading a real charge on novel biomarker techniques including the idea of using something called proteomics, which is multiple marker testing to better understand patients on an individual level. A mixture of several biomarkers may be actually very accurate for diagnosing the presence of peripheral arterial disease in patients, better than clinical means in order to recognize the diagnosis. So basically, a simple blood test might be good enough to say that a patient has obstructed lower extremity vasculature if, for example, they are complaining about symptoms in their legs. It really says that with these more refined blood tests, we can detect things that, once again, clinically speaking would not have otherwise been obviously present.

So, our team is looking at a number of different projects using biomarkers to identify a wide range of different cardiovascular disease states. Using blood samples drawn from our patients at the Mass General Hospital Cardiac Cath Lab, we’ve now developed multiple marker panels to identify the presence of coronary artery disease, noninvasively to identify the presence of aortic stenosis, valvular heart disease noninvasively, peripheral arterial disease noninvasively, to prognosticate future amputation in patients with peripheral arterial disease. And lastly, we’ve worked out a biomarker panel that prognosticates typical major adverse cardiovascular events including myocardial infarction, stroke and death.

Each of these different panels might be used in a precision manner to identify disease and also help clinicians make decisions about therapy intervention. And that is really where the biomarker field is heading. It's gone from a novelty where we’ve identified biomarkers that may be abnormal in patients with cardiovascular disease to now representing the key to precision medicine for applying novel therapies to treat these individual disease states.

Refer a patient to the Mass General Heart Center