Potential blood test for heart failure risk 

Study funded by British Heart Foundation suggests that testing for NPY protein could help predict progress of heart failure and so guide treatment. 

More than 1m people in the UK are thought to be living with heart failure, and some 200,000 new diagnoses are made each year. Heart failure is caused when the heart is unable to pump blood around the body in the way it normally should. The result is reduced quality of life, frequent visits to hospital – and there is currently no cure. 

Photo by Jesse Orrico

Anything that can be done to help identify those at risk and predict the progress of such failure would, of course, be very welcome. 

A recent study published in the European Journal of Heart Failure suggests that a simple blood test could make a huge difference. The British Heart Foundation, which funded the study, says researchers continue to investigate – but that such a test could be in common use within the next five years. 

• Read the paper, ‘Neuropeptide Y is elevated in heart failure and is an independent predictor of outcomes’ 

The study found that, during the three years it was conducted, patients with the highest levels of neuropeptide Y (NPY) protein in their blood were 50% more likely to die from heart complications. NPY is released by nerves within the heart in response to high levels of stress and can in turn trigger potentially dangerous symptoms such as irregular heart rhythms or cause constrictions of the smallest blood vessels in the heart muscle. This means the heart must work harder and causes the contraction of blood vessels going into the heart. 

The new research was led by Neil Herring, Professor of Cardiovascular Medicine and Consultant Cardiologist at the University of Oxford, working in collaboration with Professor Pardeep Jhund at the University of Glasgow. The team used data from more than 800 participants at different stages of heart failure, with participants measured for levels of the hormone B-Type Natriuretic Peptide (BNP), a hormone that is currently used to diagnose heart failure. 

In addition, blood pressure and echocardiograms – a type of ultrasound heart scan – were also analysed. Adjusted for known factors that can influence the progress of heart failure such as age, kidney function, how well the heart pumps and BNP levels, it was found that the third of patients with high levels of NPY had a 50% higher risk of dying from a heart complication in the three-year follow-up period, compared to those with low levels of NPY. 

Notably, those with high levels of NPY were not admitted to hospital any more frequently during this three-year period than other participants. The researchers suggest a link between NPY and abnormal heart rhythms which may result in cardiac arrests that occur outside hospital settings – so that the connection has otherwise so far been missed. By measuring levels of NPY as well as BNP, there may be a better chance of pinpointing those at risk, which in turn can aid healthcare professionals in deciding the best course of treatment.  

For example, a patient considered at risk might benefit from being fitted with an implantable cardioverter defibrillator (ICD). The team will now carry out larger trials to investigate the potential of the test. If supported by such evidence, the test could be in regular use within the next five years. 

Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, says: ‘This new research suggests that a new, cheap and simple blood test, could help us in future to more accurately spot which patients with heart failure are at highest risk of early death. Measuring neuropeptide Y levels could in future offer healthcare professionals greater insights into how a patient’s heart failure is likely to progress, in particular whether those with high levels of neuropeptide Y would benefit from additional treatment to reduce their higher risk. It is only through funding lifesaving research like this that we can continue to push the boundaries and ensure that people with heart failure receive the best and most suitable treatment to help them live well.’ 

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