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Non-natriuretic peptide biomarkers in heart failure with preserved and reduced ejection fraction

Evangelos Oikonomou1, Georgia Vogiatzi1, Sotiris Tsalamandris1

  • 1Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School, Athens, 11528, Greece.

Biomarkers in Medicine
|June 6, 2018
PubMed

Insights

Novel biomarkers aid in heart failure (HF) management. This review details non-natriuretic peptide biomarkers for HF with preserved and reduced ejection fraction, highlighting their diagnostic and prognostic roles.

Area of Science:

  • Cardiology
  • Biomarker Research
  • Heart Failure Pathophysiology

Background:

  • Heart failure (HF) presents as two distinct entities: HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).
  • While natriuretic peptides are established HF biomarkers, novel non-natriuretic peptide biomarkers offer additional diagnostic and prognostic value.
  • Understanding the differences in biomarker application between HFrEF and HFpEF is crucial for effective patient management.

Purpose of the Study:

  • To review and compare the application of non-natriuretic peptide biomarkers in patients with HF.
  • To delineate the distinct roles of these biomarkers in HF with preserved ejection fraction (HFpEF) versus HF with reduced ejection fraction (HFrEF).
  • To summarize the diagnostic and prognostic utility of novel biomarkers beyond natriuretic peptides in HF.

Main Methods:

  • Literature review of current research on non-natriuretic peptide biomarkers in heart failure.
  • Analysis of studies investigating biomarkers for myocardial fibrosis, renal impairment, and inflammation in HF.
  • Comparative assessment of biomarker performance in HFrEF and HFpEF populations.

Main Results:

  • Biomarkers of myocardial fibrosis show limited diagnostic yield in acute HF but offer prognostic insights, particularly in HFpEF.
  • Biomarkers of renal impairment independently predict worse prognosis in HF, irrespective of ejection fraction.
  • Inflammatory markers have not demonstrated consistent utility in patients with systolic or diastolic dysfunction.

Conclusions:

  • Non-natriuretic peptide biomarkers provide valuable prognostic information in HF, with varying utility depending on the HF subtype (HFrEF vs. HFpEF).
  • Myocardial fibrosis and renal impairment biomarkers are particularly relevant for risk stratification in HF patients.
  • Further research is warranted to fully integrate these novel biomarkers into routine HF clinical practice.

Keywords:
biomarkersfibrosisgalectin-3heart failureheart failure with preserved ejection fractionheart failure with reduced ejection fractioninflammationleft ventricle ejection fractionnatriuretic peptidesST2

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