Cardiac Biomarkers

Professor Leong Ng leads one of the foremost UK groups investigating the role of biomarkers in cardiac disease. Our work encompasses use of biomarkers for diagnosis, prognosis and monitoring of a variety of cardiovascular diseases, using targeted as well as agnostic analytical methods, and translating these to clinical use where possible.

In addition to natriuretic peptides, we have investigated the utility of several newer peptides. This work spans both their role in predicting the presence of systolic dysfunction, especially in the community, as well as markers of adverse prognosis following myocardial infarction and acute heart failure. In addition, we have identified and characterised novel peptides that may have a role in the pathophysiology of heart failure. Our expertise in measurement of these biomarkers has led to collaborative research with major international studies including the OPTIMAAL Study (Heart 2011; 97:892-898) and the Heart Protection Study (J Am Coll Cardiol. 2007 ; 49 : 311-9)

We have also evaluated Mid regional proadrenomedullin (MRproADM) as a marker of prognosis in NSTEMI (J Am Coll Cardiol. 2010: 56:125-33), and shown that it outperforms the GRACE score for prognostication which is the current standard proposed in USA and European guidelines. MRproADM may be used to guide management strategies in NSTEMI.

We have also investigated Proenkephalin (PENK) as a marker for prognosis both in myocardial infarction (J Am Coll Cardiol. 2014: 63: 280-9) and acute heart failure (J Am Coll Cardiol. 2017: 69:56-69). PENK is being evaluated as an early indicator of deterioration of renal function.

The Biomarker group also led the proteomic work package in a large EU FP7 funded programme to determine biomarkers to assess response to therapy in heart failure (BIOSTAT-CHF). We are using state of the art omic facilities (John and Lucille Van Geest Biomarker Facility) to investigate novel biomarkers in plasma and urine, for a variety of cardiovascular conditions, including heart failure with preserved ejection fraction, sudden cardiac death and aortic valve stenosis progression. Recent work has consolidated the association of a gut microbiome derivative (trimethylamine oxide) with poor prognosis in both myocardial infarction (Clin Chem. 2017; 63 : 420-428) and heart failure (Heart 2016; 102 : 841-8).