One step closer to the new frontiers of healthcare for cardiomyopathy patients

• Published in: Heart (British Cardiac Society) Vol. 109; no. 24; pp. 1808 - 1810
• Main Authors: Hazebroek, Mark R, Verdonschot, Job A J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Cardiovascular Society 01.12.2023; BMJ Publishing Group LTD
• Subjects: Biomarkers; Cardiology; cardiomyopathies; Cardiomyopathy; cardiomyopathy, hypertrophic; Cell cycle; Editorial; Heart failure; Heart transplants; Hospitalization; Kinases; Pathophysiology; Patients; Plasma; Proteins; Proteomics; cardiomyopathy, hypertrophic; cardiomyopathies
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heartjnl-2023-323095

Using random forest modelling, a 11-protein proteomics-based model was derived from the initial cohort that predicted worsening of HF defined as an increase in NYHA functional class by at least one class. [...]it would be highly interesting if such efforts could be repeated using cardiac tissue from HCM patients (eg, after a septal myectomy) for proteomics profiling. [...]several reports show the benefit of off-label treatment with trametinib in the treatment of cardiac hypertrophy in children with RASopathies, for example, Noonan and Costello syndrome.3–6 In this specific population, inhibition of the Ras pathway was able to reverse HCM and valvular obstruction; however, in adult non-syndromic forms of HCM, the therapy effect remains unknown. Besides the Ras-MAPK pathway, other clusters such as ‘focal adhesion’ and ‘PI3K-Akt signalling’ were also enriched in the plasma. Of note, in May 2019, a new American College of Cardiology/American Heart Association (ACC/AHA) strategy for the prevention of SCD was published, also including extensive fibrosis visualised by late gadolinium enhancement (LGE) on cardiac MRI.8 Herein, fibrosis was a key driver of improving the former risk stratification for SCD.9 Similar observations are seen in dilated cardiomyopathy, where presence of LGE is currently also applied to lower the threshold of ICD implantation.10 The current authors identified mainly proteins related to inflammation and cell cycle, which could lead to the development of fibrosis.