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Is it time for the practical application of biomarkers in chronic heart failure management?
Gabriel Słonina1, Tomasz Zemleduch1, Piotr Kimla1
1Department of Anesthetics, Intensive Care and Emergency Medicine, Collegium Medicum, University of Zielona Gora, Poland.
Insights
Heart failure biomarkers are crucial for prognosis. Emerging markers, particularly for cardiac fibrosis, show significant promise beyond current diagnostics like natriuretic peptides and troponins.
Area of Science:
- Cardiology
- Biomarker Discovery
- Clinical Medicine
Background:
- Chronic heart failure (CHF) is a growing concern in aging populations.
- Despite therapeutic advances, CHF prognosis remains poor, marked by hospitalizations and sudden death.
- Electrical imbalance in the myocardium contributes to CHF complications.
Discussion:
- Current diagnostic biomarkers for heart failure include natriuretic peptides and cardiac troponins.
- Numerous novel plasma biomarkers are under investigation, including galectin-3, ST-2 protein, MR-proADM, GDF-15, and uric acid.
- Markers of cardiac interstitial fibrosis demonstrate substantial prognostic value in heart failure patients.
Key Insights:
- A growing number of biomarkers are scientifically linked to heart failure patient outcomes.
- Cardiac interstitial fibrosis markers are particularly promising for predicting prognosis.
- Established biomarkers like natriuretic peptides and troponins are vital but limited.
Outlook:
- Further research is needed to validate the prognostic capabilities of novel heart failure biomarkers.
- Large-scale, randomized trials are essential to assess the clinical impact of biomarker-guided treatment decisions.
- Biomarker-guided strategies hold potential to improve patient outcomes in heart failure management.
Abstract:
Chronic heart failure is a complex clinical syndrome with increasing significance in the ageing societies of developed countries. Recent advances in both medical and instrumental therapy improve the prognosis of heart failure patients which, nevertheless, remains poor. Patients suffer from progressive pump failure reflected in increasing incidence of hospital admissions as well as sudden death due to electrical imbalance of diseased myocardium.
Aim:
The aim of the study was to review of current data on some most promising heart failure biomarkers.
Materials And Methods:
To realize the aim of the work we analyzed papers published in recent years in medical journals indexed in PubMed and Google Scholar.
Results:
Currently, only natriuretic peptides, reflecting pressure overload of the heart, and cardiac troponins, are recognized and used in practice diagnostic biomarkers of heart failure. Numerous plasma substances are being studied such as: galectin-3, ST-2 protein, MR-proADM, GDF- 15, uric acid and other. Among them, especially cardiac interstitial fibrosis markers seem to have the biggest prognostic value in heart failure patients.
Conclusions:
There is a growing number of indices with scientifically proven association with clinical outcome of heart failure patients. Large, randomized trials investigating the impact of biomarkers-guided clinical decisions on patients outcome are certainly needed.
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