Heart failure & cardiomyopathies
Proteomic Analysis of Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy (VANISH) Clinical Trial
Authors' conclusion
NT-proBNP was the most informative protein, showing a higher abundance in early compared with subclinical HCM and tracking with the phenotypic progression z-score in early-stage HCM. Studying pathways involving growth factors and extracellular matrix remodeling may yield additional insights into the mechanisms behind disease progression in sarcomevere variant carriers and early HCM.
Study context
- Population
- Pathogenic sarcomere variant carriers with early sarcomeric (G+left ventricular hypertrophy (LVH)+) or subclinical hypertrophic cardiomyopathy (HCM) (G+LVH-)participants with circulating proteins analyzed · subclinical HCM 32 · early HCM 160
- Participants
- 192 carriers
- Comparison
- Early versus subclinical HCM at baseline; convertors versus nonconvertors; valsartan versus placebo; association with changes in the phenotypic progression z-score
- Subclinical HCMn = 32
- Early HCMn = 160
- Valsartann = 81
Methodological detailsproteomic analysis of trial blood samples, proximity extension assay (Olink, Sweden), 5% false discovery rate correction
- Proteomic analysis of trial blood samples
- Proximity extension assay (Olink, Sweden)
- 5% false discovery rate correction
Primary result
As reported in the abstract
NT-proBNP
1-unit worsening in z-score associated with increase in NT-proBNP in early HCM
27%
95% CI 17–37%
Further findings
Extracellular matrix remodeling proteins
- Higher abundance (eg, tissue-type plasminogen activator) in early compared with subclinical HCM or tracked with disease progression (decorin) in early HCM
Growth factors
- Higher relative abundance in early HCM (eg, fibroblast growth factor-21)
Distinguishing convertors from nonconvertors
- No individual protein distinguished convertors from nonconvertors
- Multiprotein panels including lipocalin 2, lectin-like oxidized low-density lipoprotein receptor 1, and either NT-proBNP or interleukin-17 receptor A could distinguish these groups
Original publication
Proteomic Analysis of Valsartan for Attenuating Disease Evolution in Early Sarcomeric Hypertrophic Cardiomyopathy (VANISH) Clinical Trial. Circ Heart Fail. Published 9 May 2025. doi:10.
Summarised from the published abstract; every number is checked against it