Author + information
- Tariq Ahmad, MD, MPH and
- G. Michael Felker, MD, MHS∗ ()
- ↵∗Duke Clinical Research Institute, Division of Cardiology, 2400 Pratt Street, Room 0311 Terrace Level, Durham, North Carolina 27705
We thank Dr. Madias for his insightful comments regarding our recent publication in the Journal (1). We wholeheartedly agree with the assertion that the community of clinicians and researchers should strive for a more objective methodology by which to classify the syndrome of heart failure. This is in agreement with the recent call by the National Research Council report that calls for a new taxonomy of disease based on both clinical and molecular measures in order to provide a more accurate classification of disease, with the ultimate goal of enhancing diagnosis and treatment (2).
Drs. Louridas and Lourida suggest that we should integrate more pathophysiological information into clustering algorithms. We agree that this approach might allow for further refinement in phenotyping of heart failure and would suggest that future studies include biomarkers representing diverse biological pathways to encompass the complex biology of heart failure to the greatest extent possible.
Dr. White articulated the need for an improved classification of heart failure almost a hundred years ago (3), prompting the widespread use of measures such as New York Heart Association class. Countless therapeutic advances have been anchored in the paradigm established by existing classification schemes (New York Heart Association class, left ventricular ejection fraction). However, our understanding of heart failure has dramatically outpaced these descriptors of the syndrome; integrating biological and clinical data using advanced analytics has the potential to classify heart failure in a manner that is closer to the truth.
Please note: The HF-ACTION study was funded by grants from the National Heart, Lung, and Blood Institute (NHLBI). The biomarkers assays were funded by grants from Roche Diagnostics, BG Medicine, and Critical Diagnostics. Dr. Ahmad received support from the Daland Fellowship in Clinical Investigation; served as a consultant for Roche Diagnostics; and has received research funding from Thoratec Corporation. Dr. Felker has received research funding from BG Medicine, Critical Diagnostics, and Roche Diagnostics; and has served as a consultant for BG Medicine, Singulex, and Roche Diagnostics.
- American College of Cardiology Foundation
- Ahmad T.,
- Pencina M.J.,
- Schulte P.J.,
- et al.
- ↵(2011) Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease (The National Academies Press, Washington, DC).