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Novel biomarkers in chronic heart failure
Tariq Ahmad1, Mona Fiuzat, G Michael Felker
1Division of Cardiology, Duke University School of Medicine, 2400 Pratt Street, Durham, NC 27705, USA. ariq.ahmad@duke.edu
Insights
Emerging molecular biomarkers offer new insights into chronic heart failure (HF) pathophysiology. These novel markers may improve prediction of adverse outcomes and guide personalized treatment strategies for heart failure patients.
Area of Science:
- Biomedical science
- Cardiology
- Molecular medicine
Background:
- Chronic heart failure (HF) understanding has evolved from hemodynamics to complex molecular pathways.
- Current HF assessment and treatment increasingly focus on modifying maladaptive molecular processes.
Purpose of the Study:
- To review emerging molecular biomarkers for chronic heart failure (HF).
- To explore their potential in predicting outcomes, identifying drug targets, and assessing therapeutic efficacy.
- To discuss the role of these biomarkers in a multimarker strategy for improved HF patient care.
Main Methods:
- Review of existing literature on molecular biomarkers in chronic heart failure.
- Analysis of properties, clinical data, and potential applications of emerging biomarkers.
- Discussion of traditional biomarkers (cardiac troponin, natriuretic peptides, C-reactive protein) and their established roles.
Main Results:
- Emerging biomarkers offer unique insights into biomechanical stretch, inflammation, ventricular remodeling, myocardial injury, and renal dysfunction in chronic HF.
- Traditional biomarkers have established clinical applications but emerging ones promise enhanced predictive and therapeutic value.
Conclusions:
- Molecular biomarkers are crucial for understanding chronic HF pathophysiology.
- Emerging biomarkers hold significant potential for improving patient outcomes and guiding treatment strategies.
- A multimarker approach may lead to more effective future management of chronic heart failure.
Abstract:
Understanding of chronic heart failure (HF) has progressed from a syndrome of disordered hemodynamics caused by alterations in the structure of the heart to one that involves intertwined molecular pathways in disarray. Accordingly, the assessment and treatment of patients with chronic HF has shifted from a focus on hemodynamics to modification of maladaptive molecular processes. Accumulating evidence shows that molecular biomarkers of disease could provide a unique window into the pathophysiology of chronic HF, potentially improving our ability to predict adverse outcomes, provide novel drug targets, and even help gauge therapeutic efficacy. The more 'traditional' biomarkers such as cardiac troponin, natriuretic peptides, and C-reactive protein have been studied in large cohorts of patients with chronic HF and have relatively established clinical applications. In this Review, we summarize the properties, clinical data, and potential applications of some emerging biomarkers that could uniquely indicate the level of biomechanical stretch, inflammation, ventricular remodeling, myocardial injury, and renal dysfunction that occurs in chronic HF. We will also discuss the potential role for these biomarkers within a multimarker-based strategy that could, in the future, lead to better care for these patients.
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