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Biomarkers in heart failure: the past, current and future
Michael Sarhene1,2,3, Yili Wang1,2,3, Jing Wei1,2,3
1First teaching hospital of Tianjin University of Traditional Chinese Medicine, Number 314 Anshanxi Road, Nankai District, Tianjin, China.
Insights
Biomarkers are crucial for diagnosing and managing heart failure (HF). This review covers established and emerging HF biomarkers, guidelines, and the potential of omics for future discoveries in cardiovascular disease management.
Area of Science:
- Cardiology
- Biomarker Discovery
- Clinical Medicine
Background:
- Heart failure (HF) remains a significant health concern despite advances in cardiovascular disease treatment.
- Aging populations and increased comorbidities contribute to the rising prevalence of HF.
- Biomarker-guided management offers new approaches for HF prognostication, diagnosis, and therapy.
Purpose of the Study:
- To review current guidelines for heart failure (HF) biomarkers.
- To discuss the evaluation of novel HF biomarkers.
- To explore the role of established and emerging biomarkers in HF risk stratification, diagnosis, and clinical management.
Main Methods:
- Review of existing literature and clinical guidelines on HF biomarkers.
- Discussion of pathophysiological processes reflected by biomarkers (fibrosis, inflammation, myocardial injury, remodeling).
- Exploration of the potential of multi-marker approaches and omics technologies in HF biomarker discovery.
Main Results:
- Natriuretic peptides (BNP, NT-proBNP) are recommended for HF.
- Other biomarkers like cardiac troponins, ST2, and galectin-3 aid in HF diagnosis and prognostication.
- Multi-marker strategies are valuable due to HF's complex nature.
Conclusions:
- Established and emerging biomarkers, alongside multi-marker approaches, are vital for comprehensive HF management.
- Omics technologies hold promise for transforming future HF biomarker discovery and validation.
- Continued research is essential for optimizing biomarker utilization in clinical practice.
Abstract:
Despite the enhanced knowledge of the pathophysiology of heart failure (HF), it still remains a serious syndrome with substantial morbidity, mortality, and frequent hospitalizations. These are due to the current improvements in other cardiovascular diseases (like myocardial infarction), the aging population, and growing prevalence of comorbidities. Biomarker-guided management has brought a new dimension in prognostication, diagnosis, and therapy options. Following the recommendation of natriuretic peptides (B-type natriuretic peptide and N-terminal-proBNP), many other biomarkers have been thoroughly studied to reflect different pathophysiological processes (such as fibrosis, inflammation, myocardial injury, and remodeling) in HF and some of them (like cardiac troponins, soluble suppression of tumorigenesis-2, and galectin 3) have subsequently been recommended to aid in the diagnosis and prognostication in HF. Consequently, multi-marker approach has also been approved owing to the varied nature of HF syndrome. In this review, we discussed the guidelines available for HF biomarkers, procedures for evaluating novel markers, and the utilities of both emerging and established biomarkers for risk stratification, diagnosis, and management of HF in the clinics. We later looked at how the rapidly emerging field-OMICs, can help transform HF biomarkers discoveries and establishment.
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