The heart produces the compound secretoneurin when it is in trouble. (Illustrative photo: Microstock)

Peptide found that predicts heart failure

Patients who have relatively high concentrations of secretoneurin in their blood run higher risks of a premature death. But this compound might be just what can save patients in the future.

Heart failure is a grave condition. The heart is unable to adequately pump blood around the body. This means that vital organs get insufficient supplies of fresh blood. 

Many who have heart failure or serious arrhythmias – variations of the normal heart rhythm – die within a few years. But there are also many who live quite a while. Which patients are most at risk and need treatment to thwart an early death?

Doctors need to find indications – so-called biomarkers – which can provide them with information about the pathway a patient’s heart disease will take.

Norwegian researchers now think they have found such a biomarker – secretoneurin.

Unknown role

“The research group I’m a member of at Akershus University Hospital had studied a special group of compounds for many years and found that quantities of many of them were higher in patients with heart failure,” says Anett Hellebø Ottesen.

She is working on her PhD and is one of the researchers behind the new discovery.

“In connection with this work they saw that levels of one of the compounds were very high and appeared to be associated with higher mortalities among the patients.”

The compound – which was the neuropeptide secretoneurin – had no known role in heart disease. So this generated further research on two fronts by two groups of scientists.

One group was from Akershus University Hospital. It started examinations of heart failure patients to see whether secretoneurin levels could actually provide prognostic information.

The second group, at Oslo University Hospital, started to investigate what was going on at the cellular level. What does secretoneurin do in the heart? Why is there so much of it in these patients?

The results have recently come in.

Helps the heart

“The research on the patients showed that those with the highest levels of secretoneurin in their blood had the highest mortality,” says Ottesen.

The level of the peptide might be used to make prognoses with much more accuracy than any other indicators known to the medical profession.

Ottesen says this designates secretoneurin as a possible mortality risk indicator which can aid in selecting which patients need extra treatment and follow-ups.

Moreover, this is not the only potential use of the peptide. There is also a chance that secretoneurin can be used as a medicine for this same category of patients.

Ottesen has been involved in investigating the compound’s effect in heart cells. She says that the high levels of secretoneurin in the patients who died do not mean it was responsible for the outcomes.

On the contrary, it appears that the heart produces this peptide as a kind of medicine to counteract difficulties which have developed in the heart cells.

Long way to go

“We found out that secretoneurin restrains a central signal channel in the heart which is overactive in heart failure,” says Ottesen.

One could say that a mechanism in the heart cells has begun to work all too well. This leads to the release of too much calcium in the cells, which in turn makes it harder for the heart to contract and maintain a steady beat.

But secretoneurin impedes this hyperactivity. It also makes it feasible that patients could be treated with this substance. 

Ottesen warns, however, that much work remains before such a product can be put to clinical use. More research is needed on the peptide and it would have to be tested on animals and then on patients. We need to find out if it works as hoped and whether it has any serious side-effects.

“It takes a minimum of 20 years before such a medication can be put to use,” says the researcher.

Important contribution

The American medical professor and cardiologist Mark E. Anderson has commented on the Norwegian researchers’ findings in the Journal of the American College of Cardiology, where the results were published.

He describes the work as exciting and thinks the results are an important contribution to this field of research.

But Anderson warns against being over-expectant. He points out that the study was based on a small number of patients. So it is too early to say whether doctors can use secretoneurin to predict a patient’s risk of mortality risk.

But he writes that the Norwegian data is promising and concludes, as scientists so often do: More research is needed here.

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Read the Norwegian version of this article at forskning.no

Translated by: Glenn Ostling

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