Biomarkers and diagnostics in heart failure

Abstract

Heart failure (HF) biomarkers have dramatically impacted the way HF patients are evaluated and managed. B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are the gold standard biomarkers in determining the diagnosis and prognosis of HF, and studies on natriuretic peptide-guided HF management look promising. An array of additional biomarkers has emerged, each reflecting different pathophysiological processes in the development and progression of HF: myocardial insult, inflammation and remodeling. Novel biomarkers, such as mid-regional pro atrial natriuretic peptide (MR-proANP), mid-regional pro adrenomedullin (MR-proADM), highly sensitive troponins, soluble ST2 (sST2), growth differentiation factor (GDF)-15 and Galectin-3, show potential in determining prognosis beyond the established natriuretic peptides, but their role in the clinical care of the patient is still partially defined and more studies are needed. This article is part of a Special Issue entitled: Heart failure pathogenesis and emerging diagnostic and therapeutic interventions.

Keywords: ADHERE; ADM; ANP; AUC; Acute Decompensated Heart Failure National Registry; Adrenomedullin; Area under the curve; Atrial natriuretic peptide; B-type natriuretic peptide; BACH; BNP; Biomarker; Biomarkers in Acute Heart Failure; CI; CORONA; Confidence interval; Controlled Rosuvastatin Multinational Trial in Heart Failure; Diagnosis; GDF-15; GISSI-HF; Growth differentiation factor-15; Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca–Heart Failure; HF; HF with preserved left ventricular ejection fraction; HFpEF; HR; Hazard ratio; Heart failure; Highly sensitive troponin; Highly sensitive troponin I; Highly sensitive troponin T; ICON; International Collaborative of NT-proBNP; LVSD; Left ventricular systolic dysfunction; MI; MR-proADM; MR-proANP; Management; Mid-regional pro adrenomedullin; Mid-regional pro atrial natriuretic peptide; Myocardial infarction; N-terminal pro B-type natriuretic peptide; NHANES; NT-proBNP; NYHA; National Health and Nutrition Examination Survey; New York Heart Association; PRIDE; ProBNP Investigation of Dyspnea in the Emergency Department; Prognosis; ST2 ligand; ST2L; Soluble ST2; Val-HeFT; Valsartan Heart Failure Trial; hsTn; hsTnI; hsTnT; sST2.