Biomarkers in Advanced Heart Failure: Diagnostic and Therapeutic Insights

Abstract

Publications regarding the potential clinical utility of biomarker testing in the management of heart failure have been exponentially increasing over the last decade. The majority of non-cardiac biomarkers are commonly used to identify end-organ dysfunction or comorbidities. The diagnostic utility of natriuretic peptide testing has been well-established. Despite consistently demonstrating their prognostic values and some promising initial results, treatment guided by natriuretic peptide testing is still debated. Although cardiac troponins have been extensively used in diagnosis of myocardial injury, their primary use of biomarkers in advanced heart failure is prognostication and risk stratification. Congest Heart Fail. Congest Heart Fail. 2011;17:169-174. © 2011 Wiley Periodicals, Inc.

Subclinical hypothyroidism is an independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure

“…Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease equation: eGFR (mL/min/1.73m2) = 186 × [plasma creatinine] −1.154  × [age] −0.203  × [0.742 if female] × [1.212 if black] 18. LV ejection fraction and LV dimensions were estimated by echocardiography in a stable state of heart failure after therapy for heart failure during hospitalization.…”

Serum uric acid as a metabolic regulator of endothelial reparative processes in heart failure patients

“…Nevertheless, there are some expectations that risk stratification of the patients at early stage of CHF development and exact determination of drug giving response within CHF evolution might contribute in choosing optimal approaches of the treatment [3] . In this context a continued discover of specific diagnostic and predictive biomarkers reflected different faces of cardiac failure development is being remained very attractive and probably may improve clinical outcomes [4,5] . Moreover, serial measurements of circulating biomarkers are considered a pivotal definition of biomarker-guided therapy of CHF as strategy alternated to clinical-based approach [6,7] .…”

The Future of Pharmacogenetics in the Treatment of Heart Failure

“…Another area gaining momentum is tailoring medication in response to biomarker levels as there is considerable evidence for the relationship between brain natriuretic peptide (BNP) levels and worse prognosis in those with HF (72)(73). A recent metaanalysis looked at six trials in which patients with HF were randomized to titration of their medical therapy according to circulating BNP levels or a parallel control group (total n=1 627).…”