Ann Lab Med.  2023 May;43(3):225-236. 10.3343/alm.2023.43.3.225.

Biomarkers in Heart Failure: From Research to Clinical Practice

• Berezin AE
• Berezin AA

• KMID: 2551706
• DOI: http://doi.org/10.3343/alm.2023.43.3.225

Abstract

The aim of this narrative review is to summarize contemporary evidence on the use of circulating cardiac biomarkers of heart failure (HF) and to identify a promising biomarker model for clinical use in personalized point-of-care HF management. We discuss the reported biomarkers of HF classified into clusters, including myocardial stretch and biomechanical stress; cardiac myocyte injury; systemic, adipocyte tissue, and microvascular inflammation; cardiac fibrosis and matrix remodeling; neurohumoral activation and oxidative stress; impaired endothelial function and integrity; and renal and skeletal muscle dysfunction. We focus on the benefits and drawbacks of biomarker-guided assistance in daily clinical management of patients with HF. In addition, we provide clear information on the role of alternative biomarkers and future directions with the aim of improving the predictive ability and reproducibility of multiple biomarker models and advancing genomic, transcriptomic, proteomic, and metabolomic evaluations.

Keyword

Heart failure; Cardiac Biomarkers; Multiple Biomarker Models; Prediction; Management

Figure

• 

  Fig. 1 Circulating biomarkers of the most important conceptual clusters influencing the natural evolution of heart failure (HF). Abbreviations: BDNF, brain-derived neurotrophic factor; hs-cTn, high-sensitivity cardiac troponins; H-FABP, heart-type fatty acid-binding protein; FGF, fibroblast growth factor; Gal3, galectin-3; GDF, growth differentiation factor; GSTP1, glutathione transferase P1; IL, interleukin; KIM-1, kidney injury molecule-1; MR-proANP, mid-regional atrial natriuretic pro-peptide; MR-proADM, mid-regional pro-adrenomedullin; MPO, myeloperoxidase; sST2, soluble isoform of suppression of tumorigenicity 2; 8-OHdG, 8-hydroxy-2´-deoxyguanosine; NT-proBNP, N-terminal brain natriuretic pro-peptide; NGAL, neutrophil gelatinase-associated lipocalin; PICP, procollagen type I carboxyterminal peptide; PIIINP, pro-collagen type III aminoterminal peptide; PICP/PIIINP; MMP-9, matrix metalloproteinase 9; TIMP-1, tissue inhibitor of matrix metalloproteinase; TNF, tumor necrosis factor; Trx1, thioredoxin 1.

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