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New and emerging biomarkers of heart failure
Aldo Clerico1, Simona Vittorini, Claudio Passino
1G. Monasterio Foundation, Institute of Clinical Physiology-National Research Council and Scuola Superiore di Studi Universitari e Perfezionamento Sant'Anna, Pisa 56126, Italy. clerico@ifc.cnr.it
Insights
Diagnosing heart failure (HF) is challenging due to the lack of a single test. This review explores ideal characteristics for HF biomarkers and evaluates current assays for improved diagnosis and prognosis.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Diagnostic Accuracy
Background:
- Heart failure (HF) represents a critical endpoint for cardiovascular diseases.
- Current HF diagnosis relies on clinical judgment, often proving inadequate.
- Despite advancements, HF prognosis remains poor, necessitating better diagnostic tools.
Purpose of the Study:
- To review the characteristics of an ideal heart failure biomarker.
- To assess the analytical performance and clinical relevance of existing biomarker assays.
- To compare current biomarkers against the ideal standard for HF diagnosis and risk stratification.
Main Methods:
- Literature review of cardiovascular biomarker research.
- Analysis of analytical performance and clinical utility of proposed HF biomarkers.
- Comparative assessment of available assays against ideal biomarker criteria.
Main Results:
- No single diagnostic test currently exists for heart failure.
- Numerous laboratory tests have been proposed, but their performance varies.
- Existing biomarkers show limitations when compared to the ideal profile for HF.
Conclusions:
- Accurate and effective biomarkers are crucial for HF diagnosis and risk stratification.
- There is a significant need for developing more efficient diagnostic and prognostic biomarkers for heart failure.
- A systematic approach is presented to guide the search for superior HF biomarkers.
Abstract:
Heart failure (HF) may be considered as the fatal finishing line of all cardiovascular disorders. There is not a single diagnostic test for HF, and its diagnosis relies on clinical judgment based on a combination of history, physical examination, and appropriate investigations. For these reasons, the accuracy of diagnosis by clinical means alone is often inadequate. Despite the enormous advances in understanding and treatment that have taken place during the last 50 years, HF continues to have a poor prognosis. Diagnosis and risk stratification of patients with HF depend on the availability of specific, accurate, and effective disease or risk markers. Thus, there is an increasing interest in the development of new cardiovascular biomarkers, and, consequently, a great number of laboratory tests have recently been proposed for their assay. In this review, we briefly discuss the characteristics of an ideal HF biomarker and describe the analytical performance and clinical relevance of available biomarker assay methods, comparing their performances with that of an ideal biomarker for HF. Finally, we present a scheme to search for more efficient diagnostic and prognostic biomarkers for HF.
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