Sex-based Differences in Heart Failure Biomarkers

Area of Science:

• Cardiology
• Biomarker Research
• Sex Differences in Medicine

Background:

• Hormonal, genetic, and fat distribution variations contribute to sex-based differences in heart failure (HF) biomarker levels.
• Current understanding of these sex-related differences and their clinical impact on HF management is limited.
• Recent studies confirm distinct HF biomarker profiles between women and men.

Purpose of the Study:

• To review the dynamics of HF biomarkers concerning sex and various clinical situations.
• To determine if observed sex differences in biomarkers affect their utility in diagnosing and monitoring HF patients.
• To explore the potential for sex-specific diagnostic criteria in HF management.

Main Methods:

• Literature review of recent studies on HF biomarkers and sex differences.
• Analysis of biomarker profiles in women versus men, including markers for cardiac stretch, fibrosis, injury, and inflammation.
• Evaluation of evidence supporting a multimarker approach and sex-specific diagnostic models.

Main Results:

• Women exhibit higher levels of natriuretic peptides (NP) and galectin-3 (markers of cardiac stretch and fibrosis).
• Men demonstrate higher levels of cardiac troponin (cTn) and soluble ST2 (sST2) (markers of cardiac injury and inflammation).
• Emerging evidence suggests a multimarker strategy improves risk stratification in HF.

Conclusions:

• Sex-specific differences in HF biomarker profiles are well-established.
• These differences necessitate further investigation to refine their application in HF diagnosis and follow-up.
• Development of sex-specific diagnostic criteria may enhance HF management strategies.