Top Things to Know: Heart Failure in the Era of Precision Medicine: A Scientific Statement From the American Heart Association
Published: September 12, 2019
- One in five people in the U.S. will develop heart failure (HF) in their lifetime. Early diagnosis and better understanding of the pathophysiology of this disease are critical to optimal treatment and outcomes.
- The “omics”—genomics, pharmacogenomics, epigenomics, proteomics, metabolomics, and microbiomics - of HF represent rapidly expanding fields of science.
- This statement provides a comprehensive overview of the current state of omics as they relate to the development and progression of HF, the statement explores current and potential future applications of these data for precision medicine.
- The approach to clinical genetic testing in a patient with HF should be tailored to the underlying pathogenesis.
- The cellular location and function of genetic variants, coupled with the use of transgenic animal models and newer molecular techniques, offer important insight into HF pathophysiology and progression.
- Differences in epigenomic patterns have led to identification of novel pathways in HF and may lead to the development of novel HF therapeutics.
- New approaches can assess hundreds or thousands of protein markers simultaneously. Additional research is needed to validate novel biomarkers so they can better inform therapeutic choices.
- Metabolomics has led to important insights into the pathophysiology of HF and has been used for predicting, detecting, and evaluating HF progression. In addition, metabolomics may prove useful to guide therapy.
- Early research has shown improved outcomes in HF patients by modifying the gut microbiome, suggesting that this may be an important component of HF treatment in the future.
- Advances derived from omic investigations may facilitate future novel HF treatments.
Citation
Cresci S, Pereira NL, Ahmad F, Byku M, de las Fuentes L, Lanfear DE, Reilly CM, Owens AT, Wolf MJ, on behalf of the American Heart Association Council on Genomic and Precision Medicine, Council on Cardiovascular and Stroke Nursing, and Council on Quality of Care and Outcomes Research. Heart failure in the era of precision medicine: a scientific statement from the American Heart Association [published online ahead of issue September 12, 2019]. Circ Genom Precis Med. 2019,12:e000058. doi: 10.1161/HCG.0000000000000058.