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Penn Medicine collaborates with Bristol Myers Squibb, a pharma company, to study a protein fragment involved in heart failure. Credit: Riley Guggenhime

A recent study by Perelman School of Medicine researchers found that a protein fragment found in the bloodstream is associated with poorer outcomes in patients with a subtype of heart failure.

The study, published in The New England Journal of Medicine on Sept. 13, focused on determining if the protein, a biomarker, has stronger associations with poor outcomes such as hospital admissions or death. The study focused on a type of heart failure called heart failure with preserved ejection fraction, or HFpEF, and found that the bloodstream levels of a protein fragment called endotrophin can help predict outcomes in HFpEF patients. 

In the future, the results of this study could help doctors decide to give patients who have higher levels of the protein, and thus are more likely to have poorer outcomes, more aggressive treatments.

Heart failure affects over 6 million adults in the United States and was associated with over 350,000 deaths in 2018. Heart failure occurs when the heart muscle pumps poorly, meaning it does not pump enough blood or oxygen to the organs. HFpEF is a form of heart failure where the heart pumps normally but fails to fill with blood properly. It affects almost half of all patients with heart failure.

Lead researcher and Penn Medicine professor Julio Chirinos said the study was driven by the need to identify better predictive tools for HFpEF. The research found that endotrophin levels in the bloodstream were a better predictor of severe outcomes than existing predictors.

The study was created through the partnership through the Global Heart Failure Consortium, a joint effort between the Perelman School of Medicine and Bristol Myers Squibb, a pharmaceutical company. Chirinos co-first-authored the study with BMS Scientific Director Lei Zhao and Nordic Bioscience scientist Alexander L. Reese-Petersen.

Chirinos told Penn Medicine that researchers hope to develop an endotrophin blood test that clinicians can administer to determine the risk of HFpEF patients. This research is already underway with collaborating pharmaceutical companies. 

“In addition to helping us gauge the risks faced by HFpEF patients, endotrophin could give us important clues to the biological processes underlying poor outcomes in this form of heart failure — and might even be a target for treatment,” Chirinos said.