Biomarkers and Heart Failure

Hanna Gaggin, MD, MPH, clinical investigator and cardiologist in the Massachusetts General Hospital Heart Center, is passionate about helping patients with preserved ejection fraction and type 2 myocardial infarction, neither of which is well understood. So far, her research has entailed examining biomarkers in patients with preserved ejection fractions, and has made progress in finding treatment options. However, the prognosis for type 2 MI remains poor. Dr. Gaggin hopes to advance type 2 MI investigation to find new treatment pathways in order to help these patients.

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Transcript

I think there are two really important topics that I love, and I want to kind of spend the rest of my life looking at what happens in these patients. Number one is patients with heart failure with preserved ejection fraction. Millions of people are affected by heart failure and yet 50% of the patients who are affected with heart failure, those with preserved ejection fraction, we just don't know anything about. We are beginning to understand what is going on and some of the progress we have made in our research lab is looking at the biomarkers in these patients with heart failure.

We're beginning to understand the pathophysiology behind them, we're beginning to understand what are some of the treatment options that may suggest benefit to these patients, and that's something I think we can really make a lot of progress on.

The other group that we are looking at is patients with something called a type 2 MI or type 2 myocardial infarction. It's commonly called demand-supply mismatch related myocardial infarction. These are patients that we diagnosed them as having MI, but it's not because of narrowed coronary artery disease or because of coronary artery ischemia, but it's because of other factors, external factors, that are affecting them. These patients have prognosis that's as bad as people with type 1 MI, acute coronary syndrome or even worse than, but we don't have any treatment options for them. We don't even understand what is causing it, what is the critical link that is leading to these myocardial infarctions.

So we want to study these patients in the CASABLANCA study with 1,251 patients undergoing angiography, and we found that if you have type 2 MI, then in the subsequent years you're more likely to have major cardiovascular adverse events, all cause mortality, cardiovascular mortality or even heart failure, two to three times more likely than those who did not. And those are patients who I feel are so helpless because we don't have anything to offer them and I mean, I feel very helpless taking care of these patients because they're really sick and I know their prognosis is poor, but I don't have any tools to offer them any medications, any treatment pathways, and I want try to find something in order to help them.

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