Biomarkers for Diagnosis and Prognosis of Acute Heart Failure

Abstract

High mortality, morbility and hospitalization as a result of acute heart failure (AHF) represents an increasing public health dilemma. A prompt and appropriate therapeutic approach in the management of AHF has been demonstrated to be of great importance in reducing patient mortality and in-hospital length of stay. As consequence, at the moment of patient presentation, it is of great importance to make a fast and accurate diagnosis and risk stratification. Although an global clinical evaluation is mandatory, in some cases the signs and instrumental findings are not sufficient for a complete patient's diagnosis and risk stratifications. Multiple studies demonstrated that biomarkers assessment plus clinical judgement provide additional diagnostic and prognostic value in AHF patients. Moreover, data from the literature demonstrated the utility of a multimarkers approach in patients with heart failure in order to ameliorate diagnostic and prognostic accuracy. This paper is dedicated to addressing the actual state of the art on the utility in the management of acute heart failure of the following biomarkers: natriuretic peptides, procalcitonin, MRproADM, copeptine, neutrophil gelatinase associated lipocalin and galectin 3.

Biomarkers in the management of acute heart failure: state of the art and role in COVID‐19 era

“… 9 , 10 The ANP and BNP are secreted by atrial and ventricular myocytes respectively as a direct response to stretching caused by volume or pressure. 9 , 10 , 11 …”

“…9,10 The ANP and BNP are secreted by atrial and ventricular myocytes respectively as a direct response to stretching caused by volume or pressure. [9][10][11] Both ANP and BNP are synthesized as precursor propeptide pro-ANP and pro-BNP. The pro-ANP is deposited in a reservoir of cytosolic granules and is released on demand whereas pro-BNP is synthesized de novo as a response to ventricular stretching.…”

“…The NPs include atrial natriuretic peptide (ANP), B-type or brain natriuretic peptide (BNP), inactive form of BNP, N-terminal pro B-type natriuretic peptide (NT-proBNP), C-type and D-type natriuretic peptides (Figure 2). 9,10 The ANP and BNP are secreted by atrial and ventricular myocytes respectively as a direct response to stretching caused by volume or pressure. [9][10][11] Both ANP and BNP are synthesized as precursor propeptide pro-ANP and pro-BNP.…”