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Sex Differences in Circulating Biomarkers of Heart Failure
Roopa A Rao1, Anju Bhardwaj2, Mrudula Munagala3
1Division of Cardiovascular Medicine, Indiana University School of Medicine, 1801, N Senate Blvd, Indianapolis, IN, 46202, USA. rrao@iuhealth.org.
Insights
Sex differences in heart failure biomarkers are evident, but their clinical impact remains unclear. Further research is needed to understand these variations for better diagnosis and treatment in men and women.
Area of Science:
- Cardiology
- Biomarker Research
- Sex Differences in Medicine
Background:
- Growing evidence highlights sex-based disparities in heart failure.
- The clinical significance of sex-specific thresholds for cardiac biomarkers is not well-defined.
- Understanding these differences is crucial for personalized medicine in cardiovascular disease.
Purpose of the Study:
- To review current understanding of sex differences in cardiac biomarkers in heart failure.
- To explore the clinical relevance of these sex-specific biomarker thresholds.
- To identify knowledge gaps and emerging research areas in sex-specific heart failure biomarker studies.
Main Methods:
- Review of recent scientific literature on sex differences in heart failure biomarkers.
- Analysis of studies investigating differential biomarker thresholds in males and females.
- Exploration of novel biomarkers and technologies, including proteomics and microRNAs.
Main Results:
- Females exhibit distinct thresholds for certain biomarkers, such as lower troponin and higher NT-proBNP levels.
- Clinical relevance of ST-2, Galectin 3, and other biomarkers in a sex-specific context remains ambiguous.
- Despite observed sex-related differences in biomarker expression, translation into clinical practice for diagnosis and prognostication is limited.
Conclusions:
- Sex-specific differences in heart failure biomarkers exist but require further investigation for clinical application.
- Novel biomarkers and advanced technologies like machine learning are being explored to bridge knowledge gaps.
- Personalized approaches considering sex-based variations are essential for improving heart failure management.
Purpose Of Revsiew:
Evidence is scaling up for sex differences in heart failure; however, clinical relevance of sex-specific differential thresholds for biomarkers is not clearly known. Current ambiguity warrants a further look into the sex-specific studies on cardiac biomarkers and may facilitate understanding of phenotypic presentations, clinical manifestations, and pathophysiologic pathway differences in men and women.
Recent Findings:
Recent studies have confirmed the fact that females have differential threshold for biomarkers, with lower troponin and higher NT proBNP levels. Ambiguity continues to exist in the clinical relevance of ST-2, Galectin 3, and other biomarkers. Novel biomarkers, proteomic biomarkers, and circulating micro RNAs with machine learning are actively being explored. Biomarkers in HFpEF patients with higher female representation are evolving. In recent clinical trials, sex-related difference in biomarkers is not seen despite therapeutic intervention being more effective in females compared to males. Sex-related difference exists in the expression of biomarkers in health and in various disease states of heart failure. However, this differentiation has not effectively translated into the clinical practice in terms of diagnostic studies or prognostication. Active exploration to bridge the knowledge gap and novel technologies can shed more light in this area.
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