Screening for ventricular remodeling

Area of Science:

• Cardiology
• Preventive Medicine
• Biomarker Research

Background:

• Current guidelines advocate for early heart failure (HF) prevention by identifying preclinical disease.
• Left ventricular (LV) remodeling, a precursor to HF, is a key target in asymptomatic populations.
• Assessing LV mass, systolic, and diastolic dysfunction are potential screening targets.

Purpose of the Study:

• To evaluate the effectiveness of plasma natriuretic peptides (NP) for screening asymptomatic individuals for LV remodeling.
• To explore the utility of sequential screening strategies in identifying asymptomatic LV systolic dysfunction cost-effectively.

Main Methods:

• Review of investigations on plasma NP performance for detecting LV remodeling phenotypes.
• Analysis of NP performance in general populations versus high-risk subgroups (e.g., older men with hypertension).
• Examination of recent reports on sequential screening strategies combining NP and echocardiography.

Main Results:

• Plasma NP performance is generally suboptimal for identifying LV remodeling in the general asymptomatic population.
• Targeting high-risk individuals improves NP performance for detecting LV remodeling.
• LV systolic dysfunction prevalence in women is too low to warrant general screening.
• Sequential screening strategies show promise for cost-effective identification of asymptomatic LV systolic dysfunction.

Conclusions:

• Current NP screening for LV remodeling in asymptomatic individuals has limitations.
• Sequential screening approaches combining NP and echocardiography may offer a more effective and cost-efficient solution.
• Further research is needed to validate these sequential screening strategies for population-wide application.