Heart Failure
Research by this group focuses on clinical investigation on Heart Failure. We approach clinical presentation and natural history of this condition. Focusing mainly on biomarkers as diagnostic tools, helping in prognosis exercise and helping clinical decision. The diagnosis of Heart Failure is based on signs and symptoms that are non-specific and tolls to help clinicians to a positive diagnosis are warranted. The identification of patients with ominous prognosis offers to clinicians an opportunity to detect patients that could benefit from more close and aggressive approach. In this context, biomarkers are under intense clinical investigation and natriuretic peptides have been proven to be robust prognostic indexes.
Additionally we focus on co-morbidities on Heart Failure. The vision of Heart Failure as a systemic condition lead us to develop investigations on the interplay between the heart and the lung, the heart and the kidney. More recently we looked to the relationship between heart and liver.
For over a decade, we have conducted innovative research on the usefulness and use of natriuretic peptides for diagnosis and prognosis in heart failure syndromes. We have described for the first time that acute heart failure patients who fail to decrease b-type natriuretic peptide during an acute episode were at very higher risk of adverse outcome. This observation was latter reproduced by other groups. More recently, we integrated a European network that duplicated these results around Europe.
We observed that natriuretic peptides are attenuated in severe heart failure. We have showed that mal-nutrition is associated with adverse outcome in these patients. These observations were verified using different nutritional indexes.
The dialog between the heart and kidney has been also a topic of our group. We reported for the first time than NGAL – a biomarker of kidney injury – can identify patients at very high risk of renal dysfunction on acute heart failure patients. Furthermore, we observe that this biomarker as prognostic value in acute patients. These preliminary results generate the hypothesis that modulation of venous pressure – a major factor leading to renal dysfunction in acute patients, can be associated with better outcomes in these patients with ominous prognosis.
More recently, we are exploring new biomarkers in Heart failure prognosis – GDF15, CA 125.