Heart failure is a significant global health issue, affecting millions of individuals across the world. A critical concern within this realm is the delayed diagnosis and misidentification often experienced by women, particularly concerning the more prevalent types of heart failure.
At its core, heart failure indicates the heart’s inability to pump sufficient blood to meet the needs of the body’s cells. This condition is typically categorized into two primary types:
- **Heart Failure with Reduced Ejection Fraction (HFrEF)**: The heart has a diminished capacity to pump blood effectively.
- **Heart Failure with Preserved Ejection Fraction (HFpEF)**: The heart struggles to fill with blood adequately.
Notably, HFpEF is the most common type of heart failure, especially among older women, yet it poses challenges in terms of accurate diagnosis.
Tailored Treatments for Varied Diagnoses
The need for differentiated diagnosis arises from the requirement for unique treatment approaches for each type of heart failure. “We need to differentiate between the two types of heart failure so that we can provide accurate diagnoses to patients and, consequently, the most effective treatment,” emphasized Reza Parvan, a PhD student at the Institute for Experimental Medical Research (IEMR) at the University of Oslo.
Insufficient Biomarkers for Distinguishing Types
Biomarkers serve as essential diagnostic tools in the medical field, aiding healthcare professionals in determining the precise health status of patients. While multiple biomarkers exist for HFrEF, there is currently a lack of adequate markers to reliably distinguish between heart failure types, limiting the ability to provide detailed information to patients.
Investigation of Small Molecules for Diagnostic Clarity
In a promising turn of research, Parvan and his team are exploring small molecules as potential indicators for different types of heart failure. “We have explored how certain small molecules can function as biomarkers for diagnosing heart failure,” he stated.
The research focuses on microRNAs—tiny molecules found in the bloodstream that reflect gene expression and may signal disease status and severity. A panel consisting of four specific microRNAs has been identified, showing potential in differentiating between heart failure patients and healthy individuals.
Impact on Women’s Health
This discovery holds notable importance for women’s health. “We found that two of these microRNAs are especially relevant for women,” noted Parvan, highlighting the need to incorporate gender-specific considerations in diagnosing heart failure. This advancement is particularly vital, given that most patients with HFpEF, the most prevalent form of heart failure among the elderly, are women.
Improving Quality of Life Through Accurate Diagnoses
In total, approximately 26 million people are diagnosed with heart failure globally, though estimates suggest that the actual number may exceed 37 million due to undiagnosed cases. Parvan remarked, “More precise diagnoses lead to better management of the disease and can potentially improve the quality of life for many patients.”
Assessing Future Risk of Heart Failure
The research also indicates that these microRNAs can help predict the risk of developing heart failure and associated complications, such as hospital readmissions and heart-related deaths. With heart failure being the leading cause of global hospitalizations, the implications of these findings are profound. “Over half of patients are readmitted to the hospital within six months of discharge,” Parvan observed, emphasizing the need for effective management.
Future Directions in Research
As next steps, the research team plans to validate these biomarker panels through clinical trials across various patient groups. “This will ensure that our results are robust and reliable,” Parvan elaborated. The studies will consider adding other biomarkers, including proteins and genetic markers, particularly for patients with heart or liver transplants.
Pioneering Medical Diagnostics
The work undertaken by Parvan and colleagues marks a significant advancement towards personalized medicine in heart failure treatment. Gustavo J. J. da Silva, a postdoctoral fellow at IEMR, stated, “With this research, we position ourselves at the forefront of innovative medical diagnostics, focusing on future developments of RNA-based test kits.”
Moreover, Da Silva indicated that their research methods could extend beyond heart failure, allowing for broader applications in both cardiac and non-cardiac patients. “We may be able to identify other types of markers, from proteins and genetic markers to imaging technologies. This opens the possibility of developing multimodal biomarker panels for various clinical needs,” he concluded.
References:
1. Parvan R, Rolim N, Gevaert AB, et al. Multi‐microRNA diagnostic panel for heart failure with preserved ejection fraction in preclinical and clinical settings. ESC Heart Failure. 2025;12(4):3028-3041. doi: 10.1002/ehf2.15324
2. Parvan R, Becker V, Hosseinpour M, et al. Prognostic and predictive microRNA panels for heart failure patients with reduced or preserved ejection fraction: a meta-analysis of Kaplan–Meier-based individual patient data. BMC Med. 2025;23(1):409. doi: 10.1186/s12916-025-04238-0
