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Biomarkers in cardiovascular disease: beyond natriuretic peptides
1Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, United Kingdom. aboswood@rvc.ac.uk
Insights
Natriuretic peptides are key circulating markers for canine and feline cardiovascular disease. Research suggests combining multiple biomarkers may improve patient risk assessment and treatment strategies.
Area of Science:
- Veterinary Cardiology
- Biomarker Discovery
Background:
- Natriuretic peptides are established circulating markers for cardiovascular disease in dogs and cats.
- Numerous other biomarkers exist for evaluating cardiovascular patients, including markers of myocyte injury, stress, remodeling, endothelial function, inflammation, and neurohormonal activity.
Purpose of the Study:
- To explore the potential of various circulating markers beyond natriuretic peptides in veterinary cardiovascular medicine.
- To investigate the utility of multi-marker evaluation for diagnosing cardiovascular disease and identifying at-risk patients.
Main Methods:
- Review of existing literature on circulating biomarkers in human and veterinary cardiovascular disease.
- Analysis of marker categories including myocyte injury (troponins), stress (adrenomedullin, ST2), remodeling (MMPs, PIIINP), endothelial function (dimethylarginines), inflammation (CRP, ILs, TNF-α), and neurohormones.
Main Results:
- The diagnostic and prognostic potential of many circulating markers remains underexplored in veterinary patients.
- Evidence suggests that a multi-marker approach may offer superior diagnostic and prognostic value compared to single markers.
Conclusions:
- Further research is needed to fully characterize the clinical utility of multi-marker panels in veterinary cardiovascular disease.
- Biomarkers can be used to identify patients at increased risk of complications or death and may guide therapeutic interventions.
Abstract:
Currently natriuretic peptides are justifiably regarded as the most promising circulating markers of cardiovascular disease in dogs and cats, but there are many other markers that can be used in the evaluation of such patients. There are markers of myocyte injury typified by troponins I and T; markers of myocyte stress including adrenomedullin and ST2; markers of remodeling including matrix metalloproteinases, tissue inhibitors of metalloproteinases and collagen molecules (PIIINP); markers of endothelial function including dimethylarginines and nitric oxide metabolites; markers of inflammation including C-reactive protein, several interleukins and tumor necrosis factor alpha; and finally neurohormonal markers. The potential of many of these markers has at best been only partially explored in veterinary patients. Evidence emerging from studies of human and in some cases veterinary patients suggests that using multiple markers may be superior to using single markers alone. As well as evaluating markers for their diagnostic value they should be considered as methods of identification of patients at increased risk of experiencing complications or death. Future areas of research in this field could include improved characterization of the clinical utility of multi-marker evaluation in veterinary patients and using markers to identify patients that may benefit from particular interventions.
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