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Novel heart failure biomarkers: why do we fail to exploit their potential?
Arnold Piek1, Weijie Du1,2, Rudolf A de Boer1
1a Department of Cardiology , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands.
Critical Reviews in Clinical Laboratory Sciences
|April 18, 2018
Summary
Novel heart failure (HF) biomarkers show promise but lack clinical utility due to non-specific pathology. Preclinical studies in animal models are crucial to reveal their full potential for HF diagnosis and prognosis.
Area of Science:
- Cardiology
- Biomarker Discovery
- Translational Medicine
Background:
- Plasma biomarkers are vital for heart failure (HF) diagnosis and prognosis.
- Despite extensive research, novel HF biomarkers struggle with clinical implementation.
- Established biomarkers like natriuretic peptides and troponins are widely used, unlike newer candidates.
Purpose of the Study:
- To review established and novel plasma biomarkers for heart failure.
- To discuss the biological basis and clinical utility of these biomarkers.
- To propose future research directions for validating novel HF biomarkers.
Main Methods:
- Literature review of studies on HF biomarkers.
- Analysis of the biological mechanisms underlying biomarker function.
- Discussion of clinical guidelines and implementation challenges.
Main Results:
- Established biomarkers (natriuretic peptides, hsTn) are clinically validated.
- Novel biomarkers (Gal-3, sST2, HE4, IGFBP-7, H-FABP, sCD146, IL-6, GDF-15, PCT, ADM, miRNAs, 5-oxoproline) often reflect general pathologies (fibrosis, inflammation, cell death).
- Limited cardiac specificity hinders the clinical utility of many novel biomarkers.
Conclusions:
- Most novel HF biomarkers lack specificity, complicating their direct link to HF.
- Further preclinical research, particularly in animal models, is essential to understand and validate novel HF biomarkers.
- Integrating preclinical and clinical findings will be key to unlocking the diagnostic and prognostic potential of new HF biomarkers.
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