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Published on: January 28, 2020
Biomarkers in cardiogenic shock
Johan Lassus1, Tuukka Tarvasmäki1, Heli Tolppanen1
1Helsinki University and Helsinki University Hospital, Heart and Lung Center, Department of Cardiology, Helsinki, Finland.
Insights
Biomarkers aid in diagnosing and monitoring cardiogenic shock (CS), a critical condition. Novel biomarkers offer improved understanding of CS pathophysiology and patient risk stratification for better outcomes.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Critical Care
Background:
- Cardiogenic shock (CS) is a life-threatening condition characterized by cardiac dysfunction, hypoperfusion, and organ injury.
- Established biomarkers like lactate and troponins are used for CS diagnosis and monitoring.
- The complex pathophysiology involves hemodynamic instability, inflammation, and multi-organ dysfunction, necessitating advanced assessment tools.
Purpose of the Study:
- To review the clinical utility of various biomarkers in the diagnosis, monitoring, and risk stratification of cardiogenic shock.
- To discuss the role of established and novel biomarkers in understanding CS pathophysiology and predicting patient outcomes.
- To highlight biomarkers for organ injury, dysfunction, and metabolism in the context of CS management.
Main Methods:
- Literature review focusing on the clinical application of biomarkers in cardiogenic shock.
- Analysis of established markers (lactate, troponins, renal function) and novel markers (GDF-15, sST2, DPP).
- Evaluation of biomarker prognostic properties for mortality risk prediction in CS patients.
Main Results:
- Established biomarkers are crucial for initial CS diagnosis and monitoring.
- Novel biomarkers (GDF-15, sST2, DPP) show promise in elucidating CS pathophysiology and improving risk stratification.
- Biomarkers of organ injury, dysfunction, and metabolism are essential for comprehensive CS management.
Conclusions:
- Biomarkers play a vital role in the clinical management of cardiogenic shock, from diagnosis to risk prediction.
- Integrating novel biomarkers can enhance our understanding of CS complexity and guide therapeutic strategies.
- Prognostic biomarker data is critical for effective mortality risk stratification in patients with cardiogenic shock.
Abstract:
Biomarkers are useful for diagnosis, disease monitoring and risk stratification in cardiovascular disease. Cardiogenic shock (CS) is a medical emergency caused by a primary cardiac insult resulting in inadequate cardiac output, hypoperfusion and organ injury. The pathophysiology of CS is complex involving hemodynamic and circulatory disturbances, inflammation and organ dysfunction. CS is associated with high short-term mortality. Biomarkers such as lactate, cardiac troponins and markers of renal function are established in the diagnosis and monitoring of CS. Evaluation of organ injury and dysfunction is essential for the management. Biomarkers of inflammation and novel biomarkers such as growth differentiating factor-15 (GDF-15), sST2 and dipeptidyl dipeptidase 3 (DPP) may improve our understanding of pathophysiology and clinical course. The prognostic properties of these biomarkers aids in risk stratification and are incorporated as clinical tools for mortality risk prediction in CS. In this review, the role of biomarkers in CS will be discussed. Markers of organ injury and dysfunction, metabolism and novel biomarkers will be covered from a clinical perspective.
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