[Biomarkers in heart failure: an update]

Heart failure (HF) represents the final common pathway of cardiovascular diseases. Prognosis of HF remains dismal despite a better understanding of its pathophysiology and advances in diagnostics and therapeutics. HF is a complex syndrome, with an extensive influence on vital organ perfusion and function resulting from hemodynamic alterations and with marked arrhythmogenicity, following the development of structural abnormalities and adrenergic activation. Therefore, current clinical and instrumental approach to the HF syndrome should be complemented by novel decision-making strategies, with potential in early diagnosis as well as in prognostication and therapeutic definition. In this view, there is growing experimental and clinical interest in the use of biomarkers, namely B-type natriuretic peptides, whose role in diagnosis, risk stratification and patients' follow-up is well recognized. A new targeted approach is envisaged in the next future for the management of the heterogeneous clinical phenotype of HF, likely based on biomarker tracking specific pathophysiologic pathways of disease progression.