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Genomic profiles predict organ function, outcomes in advanced HF
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Preoperative peripheral blood mononuclear cell gene-expression profiles predicted early changes in organ function and long-term outcomes in patients with advanced HF who had a mechanical circulatory support device implanted, according to a study published in PLOS ONE.
“Our data suggest that the preoperative dynamic recovery potential, rather than the static severity of [organ dysfunction], is the key prognostic property to restoring equilibrium after surgery,” Galyna Bondar, PhD, assistant researcher at David Geffen School of Medicine at UCLA, and colleagues wrote. “This also presents the possibility of using a preoperative blood sample to identify [advanced] HF patients who may have a high chance of early postoperative recovery and a potentially good long-term prognosis.”
Researchers analyzed data from 29 patients with advanced HF who underwent mechanical circulatory support surgery from August 2012 to August 2014. Preoperative peripheral blood mononuclear cell samples and clinical data were collected 1 day before surgery. Clinical data were also reviewed 8 days after surgery.
Patients were categorized based on whether their organ function showed improvement or not. Organ function of patients in the improving group were expected to recover up to 5 days after surgery and noticeably recover by day 8 postoperatively. Patients in the not improving group would not have improved organ function, which may impact long-term survival.
The clinical outcome of interest was organ function improvement from 1 day before to 8 days after surgery.
Most patients (n = 28) survived 8 days after surgery. Of those patients, 88% of patients in the improving group and 27% of those in the not improving group survived at 1 year.
Between the two groups, 28 genes were differentially expressed 8 days postoperatively and 12 genes overlapped in patients who survived at 1 year. These patients also had 105 differentially expressed genes, of which 12 overlapped with the 28 genes that were associated with organ function improvement 8 days after surgery.
“Since HF is a major public health concern due to its tremendous societal and economic burden, with estimated costs in the U.S. of $37.2 billion in 2009 and with expectations to increase to $97 billion by 2030, our proposed prediction test would simultaneously allow to tailor the individual patient’s personal benefits and also enhance cost-effectiveness in U.S. health care,” Bondar and colleagues wrote. – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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