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Disease and treatment

Blood test identifies life-threatening shortness of breath

Struggling to breathe is a sign that the heart and lungs are having difficulty keeping up. When this happens for no apparent reason, it may be a sign of serious illness. By measuring four biomarkers in a blood test, researchers can now identify the breathless people who may be in danger of dying so that doctors can focus on them.

Everyone knows the feeling of being out of breath after running up the stairs slightly too fast. Being out of breath is normal when exerting oneself physically. However, for some people, shortness of breath is a constant burden that feels like a heavy weight on their chest. In medical language, the condition is called dyspnea, and doctors pay close attention to it because people with acute dyspnea often have heart problems and resulting high mortality.

Unfortunately, people with acute dyspnea are also a large heterogeneous group, and identifying the people at highest risk is therefore not easy. Swedish researchers at Skåne University Hospital in Malmö have made this task easier by developing a blood test that can predict who has the highest risk of being rehospitalized or of dying.

The researchers followed 65 inpatients with dyspnea at Skåne University Hospital. They were asked to self-rate their dyspnea using the widely-used Dyspnea Severity Scale. Then they were given a blood test that measured several biomarkers that the researchers believed could be related to heart disease.

During the 6 months of follow-up, 40% were readmitted. Nearly one quarter died from heart disease. By examining the values of the biomarkers, the researchers identified four that were much higher among the people who were rehospitalized or had died.

Overall, the four biomarkers more reliably predicted who had the highest risk than the traditional Dyspnea Severity Scale. The researchers cannot explain exactly why these people at highest risk have much higher levels of these four biomarkers. However, the researchers think that the biomarkers can be used now to improve the risk assessment of people with shortness of breath to ascertain whether they should receive additional preventive treatment.

Cardiometabolic biomarkers are predictors of readmission and death in patients hospitalized for acute dyspnea” has been published in the American Journal of Emergency Medicine. In 2014, the Novo Nordisk Foundation awarded a grant to a main author, Olle Melander, for the project Integration of Cardiovascular Endocrinology, Cardiometabolic Plasma Biomarkers and Genomics to Improve Prediction and Primary Prevention of Cardiovascular Disease.

Olle Melander
We aim to identify novel interventions for prevention and treatment of diabetes-related cardiovascular disease (CVD). Our strategy is to identify genetic, endocrine and metabolic disturbances in humans which are causally related to disease development and are detectable many years before disease presents. We then test in both animals and in human intervention studies if manipulation of such molecular disturbances ameliorate cardiometabolic risk. A few examples of our translational research achievements include discovery of: (1) CVD genetic risk variants which identify “hidden high-risk individuals” in the population and specific pharmacological and life-style treatments which can revert that genetic risk, (2) neurotensin as a key hormone linking hyper-efficient intestinal fat absorption and storage to obesity, diabetes and CVD development and (3) high vasopressin secretion as a cause of diabetes and CVD and the potential of increased water intake to revert the risk.