HJBR Sep/Oct 2020

34 SEP / OCT 2020  I  HEALTHCARE JOURNAL OF BATON ROUGE   Healthcare Briefs • St. Francis Diner in New Iberia for its proj- ect, “Balanced Healthy Meals” • Top Box Foods Louisiana in New Orleans for its food delivery program • United Hands Youth Center, in Ferriday, for its Doty Road Community Center The COVID-19 Recovery Grants Program con- tinues to accept funding proposals from non- profit, Louisiana-based organizations that serve the Medicaid population. Grant proposals are reviewed weekly. Proposals may be approved, declined, or held for consideration for later fund- ing. Organizations with approved proposals will receive grant funds within 30 days. Additional information about COVID-19 Recov- ery Grants Program, as well as the formal RFP, are available online at www.LouisianaHealthConnect. com/grants. Questions may be directed to Com- munityGrants@LouisianaHealthConnect.com . NewTest May Predict Who Develops Certain Type of Heart Failure People with higher levels of a specific inflamma- tory marker may have a greater risk of developing a form of heart failure, according to new research that could help predict who might develop the disease. The biomarker, called GlycA, is an indicator of inflammation throughout the body. Inflammation is thought to play a pivotal role in heart failure, a chronic condition when the heart muscle doesn’t pump as well as it should. It affects an estimated 6.2 million U.S. adults. The new study, published in the American Heart Association journal Circulation: Heart Fail- ure, sought to find out if high levels of GlycA in the blood might predict two subsets of heart fail- ure: heart failure that occurs despite having a pre- served – or normal – ejection fraction, and heart failure that occurs with a reduced ejection frac- tion. Ejection fraction refers to how much blood the left ventricle pumps out into the body. Researchers studied about 14 years’ worth of data from 6,507 middle-age and older people who did not have cardiovascular disease or heart failure at the start of the study. After accounting for various factors – including high blood pres- sure and diabetes – researchers discovered peo- ple with the highest levels of GlycA had more than double the risk of developing heart fail- ure with preserved ejection fraction compared to those with the lowest levels. However, having higher biomarker levels did not impact the risk of developing the other subtype – heart failure with reduced ejection fraction. Preserved ejection fraction is when the heart contracts normally but the left ventricle doesn’t relax properly. Reduced ejection fraction is when the heart muscle does not contract effectively. “They’re really two different entities, so one (treatment) approach doesn’t fit all,” said Dr. Erin Michos, the study’s senior author. The study’s findings are particularly important, she said, because treating preserved ejection fraction is more difficult than treating reduced ejection fraction. “We don’t really have any good therapies for heart failure with preserved ejection fraction,” said Michos, associate director of preventive car- diology at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore. “The best intervention is trying to prevent it from happening in the first place through maintain- ing a normal weight, exercising, eating a healthy diet, and controlling blood pressure and blood glucose.” Since the study was observational, “We can’t show that the inflammation actually directly caused the heart failure,” she said. “Maybe having much inflammation in the body is just a marker of someone who’s sicker in general.” Still, Michos said she’d like to see GlycA testing become more routine. She also called for future research to delve into whether heart failure can be prevented by lowering GlycA levels. Dr. Ferhaan Ahmad, who was not involved in the research, called it a “novel” study that offers a new way to predict who might develop heart failure with preserved ejection fraction. “It’s a perplexing disorder about which not much is understood. The contractile function of the heart appears to be normal, and yet patients still have pretty severe heart failure symptoms,” said Ahmad, director of the Cardiovascular Genetics Program at the University of Iowa in Iowa City. Figuring out what causes heart failure with pre- served ejection fraction will be extremely chal- lenging, he said. But at least the new study gives doctors something to work with. “The big takeaway is that this may be a superior method to identify patients at higher risk of this pretty intractable disease,” Ahmad said. “And then we can intervene early to reduce the risk fac- tors we know already – obesity, diabetes, hyper- tension. If we can target those, we can reduce the future risk of developing the disease.” Why Is Obesity So Common in COVID-19 Patients? A hormone that connects the body’s metabo- lism and immune response system may explain why COVID-19 is so dangerous for people with obesity. “The problem for people with obesity is that their leptin levels are always high, and that can affect the response to a COVID-19 infection,” said Candida Rebello, PhD, RD, lead author of a new paper that traces the link between obe- sity and the virus. The hormone leptin regulates appetite and metabolism. Leptin also regulates the cells that fight infection. Leptin is produced by fat cells, and to a lesser extent, by tissues in the lungs. The more fat a person has, the more leptin circulates in their body. Elevated leptin levels hamper the body’s ability to fight off infections, in the lungs and elsewhere, Rebello said. High leptin levels promote a low- grade systemic inflammatory state. “If you have obesity, there are a number of underlying health issues that make it more dif- ficult for you to fight off a COVID-19 infection,” said John Kirwan, PhD, Pennington Biomedical Executive Director and a co-author of the review. “Your entire body, including your lungs, may be inflamed. Your immune response is likely compro- mised, and your lung capacity reduced. “Add in a virus that further weakens the body’s ability to fight infection, that can limit the body’s ability to control lung inflammation, and you have the recipe for disaster.” COVID-19 vaccine developers should take the immunocompromised state resulting from obe- sity into consideration, in much the same way they would advancing age. The researchers say the role of leptin in COV- ID-19’s development bears investigation along with the viral proteins that alter the immune