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Published on: January 28, 2020
New cardiovascular biomarkers: clinical implications in patients with valvular heart disease
Luis M Moura1, Francisco Rocha-Gonçalves, José L Zamorano
1Oporto School of Medicine, Department of Medicine, Portugal. luismoura@mail.telepac.pt
Insights
Biomarkers help detect valvular heart disease (VHD) progression and inflammation. Current and emerging biomarkers aid in diagnosing and monitoring VHD, guiding treatment decisions for better patient outcomes.
Area of Science:
- Cardiology
- Biomarker Discovery
- Inflammatory Response in Cardiovascular Disease
Background:
- Valvular heart disease (VHD) involves chronic inflammation, leading to left ventricular dysfunction and heart failure.
- Biomarkers are increasingly recognized for their role in understanding VHD pathogenesis and progression.
- Current management of VHD, especially asymptomatic cases, presents therapeutic challenges.
Purpose of the Study:
- To review the clinical and research applications of biomarkers in valvular heart disease.
- To highlight the role of biomarkers in assessing inflammation and disease progression.
- To discuss the utility of biomarkers in guiding VHD management and treatment decisions.
Main Methods:
- Literature review of current and emerging biomarkers for VHD.
- Analysis of biomarker roles in inflammation, cardiac dysfunction, and disease progression.
- Evaluation of biomarker utility in diagnosing and monitoring VHD.
Main Results:
- Biomarkers like C-reactive protein and Brain Natriuretic Peptide (BNP) are crucial for assessing inflammation and cardiac dysfunction in VHD.
- BNP aids in diagnosing and monitoring VHD progression, particularly in high-risk individuals.
- Biomarkers show potential in identifying patients who would benefit from interventions like aortic valve surgery.
Conclusions:
- Biomarkers are essential tools for understanding and managing valvular heart disease.
- Emerging biomarkers offer new avenues for early detection, risk stratification, and personalized treatment strategies.
- Further research into biomarker applications can optimize VHD patient care and surgical timing.
Abstract:
Valvular heart disease (VHD) is characterized by an ongoing, inflammatory cellular response which results in a left ventricular hemodynamic stress change in response to valvulopathy. The current inflammatory hypothesis suggests that as the heart valve disease progresses the inflammatory cytokine response is activated causing continuation of deleterious effects on the heart and vasculature. This can lead to progression of heart failure and left ventricular dysfunction. Over the last 10 years, a number of biologically active molecules, termed biomarkers, have been discovered in VHD. These can be used to detect the progression and pathogenesis of heart failure and to assess the severity of inflammation (e.g., C-reactive protein). Brain natriuretic peptide (BNP) can diagnose underlying cardiac systolic and diastolic dysfunction. In high-risk patients BNP is also considered to be a useful tool for assisting in the diagnosis and monitoring the progression of VHD. Patients with symptomatic VHD benefit from aortic valve surgery; however, management in the absence of symptoms remains challenging. While the lack of symptoms can delay aortic valve replacement, unselected premature aortic valve replacement may be associated with unbalanced risks of cardiac surgery. This review summarizes the current and emerging clinical and potential research application of specific biomarkers of VHD.
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