Climbing a few flights of stairs, the kind of regular activity you’ve done dozens of times before. Only lately it’s been a little different. You’re winded, your heart races, maybe you’re experiencing a little pain. After a short while you catch your breath, the discomfort subsides, and you return to your usual routine. It may be nothing, but it may also be signs of something quite serious – Congestive Heart Failure. Congestive heart failure is a very common medical condition that currently affects an estimated five million Americans. It’s characterized by two primary findings that happen to the heart. First in many patients not enough blood is sent out of the heart to the body so patients experience symptoms like fatigue and unusual tiredness. Second there tends to be a back up of pressure within the heart. This pressure is transmitted to the lungs which causes congestion in the lungs and this is the congestive part of congestive heart failure. The symptoms that come from this are predominately short windedness either at rest or upon exertion.
Until recently physicians have been unable to definitively diagnose Congestive Heart Failure before the most common visible symptoms occur. While still treatable, at that point it is often too late for the patient to benefit from the most effective therapies. However the FDA has recently cleared a simple blood test, developed by Bayer Diagnostics that can effectively screen for the disease even in its earliest stages. The test is based on a revolutionary diagnostic concept known as bio-markers. Dr. David Okrongly, Senior VP of Research & Development for Bayer, Diagnostics explains. “Bio-markers are secreted by cells into the blood and by measuring those bio-marker levels in the blood we can make determinations of disease states, disease prognosis, and really provide physicians a tool to really aid them in diagnosing diseases like cancer and cardio-vascular disease. Today in blood we are measuring things at levels that we could never achieve before, because of advances in technology. The advent of monoclonal antibodies that can detect very very low levels of proteins, detect nucleic acids, has really revolutionized our ability to measure very very low levels of biological materials.” It was this breakthrough technology that led researchers to the discovery of a protein called BNP and its relationship to patients with Congestive Heart Failure. BNP is secreted by the heart in response to high pressures. And when it’s released from the heart it has two effects. One is it opens up the blood vessels to lower pressure. It also causes the kidneys to pump out salts and water that further lower pressure. When patients have a disease like Congestive Heart Failure, their levels of BNP will continue to rise in response to their severity of disease. So by measuring BNP doctors can get a snap shot of where that patient is in the disease progression of Congestive Heart Failure.
In some facilities the BNP test can be run on-site, or it may be sent to a clinical laboratory. Either way it is proving to be a valuable tool for doctors to not only diagnosis patients with CHF, but to help monitor those known to have the condition and evaluate the effectiveness of prescribed treatments. Cardiologist John Dent who has used the test in his practice says, “Many patients with heart failure are seeing doctors for the first time that don’t have access to some of the more sophisticated test like echo-cardiography so a blood test like BNP means that the doctor can often make the diagnosis in the office. Adding the information from the blood test to the information that’s obtained from examining the patient, coming up with a general idea of what the patients ailment is, and then adding the value of the blood test to that to make a final decision about what further testing is needed and how likely the patient is to really have or not have CHF.” Medical experts agree that one of the key values of the test is that a lot of other diseases present with the same symptoms that congestive heart failure does, and BNP helps a physician to rule out the fact that it isn’t congestive heart failure, it might be something like asthma, or emphysema, or pneumonia and they can then get that patient onto a more appropriate therapy. And with heart disease currently costing billions of dollars a year to treat, economical and accurate tests are seen as a way to reduce the drain on an already over burdened healthcare system. Adds Dr. Dent, “Since we have so many effective treatments now for heart failure that we can offer to patients our current aspiration is to detect the problem sooner and begin the medication sooner, the BNP test helps us to do this.”
For centuries, medicine has been reactive, with physicians often hampered by their ability to combat a killer disease only when it rears its head. Today, armed with a growing battery of tests and improved diagnostics, doctors are gaining the upper hand that allows them to treat conditions at the earliest stages. Earlier treatments can often be the key to long-term survival with a chronic condition like Congestive Heart Failure.