Diagnostic and Prognostic Biomarkers in Emergency Department Heart Failure

Abstract

Heart failure is a growing public health issue worldwide. Significant challenges still remain in the diagnosis and risk stratification of acute heart failure in the emergency department. Biomarkers, with their objectivity, reproducibility, and widespread availability, have an indispensable role in improving heart failure diagnostic accuracy and risk stratification. Natriuretic peptides are perhaps the most well-known and validated biomarkers for the diagnosis of acute heart failure. They have become a routine part of the diagnostic workup of acute heart failure in many clinical settings. Natriuretic peptides along with traditional biomarkers such as troponin, creatinine, blood urea nitrogen, and serum sodium can help to identify high-risk patients who may need closer monitoring and more intensive therapy. In addition, many novel biomarkers have emerged from basic science laboratories worldwide to provide insight into different pathophysiological processes involved in heart failure. These exciting new biomarkers include mid-region proadrenomedullin (MR-proADM), C-terminal pre-pro-vasopressin (copeptin), ST2, high-sensitivity troponin, and neutrophil gelatinase-associated lipocalin (NGAL). With more experience, these new biomarkers can provide an ever clearer picture into the pathophysiology of heart failure, leading to more accurate diagnosis and better risk stratification of heart failure patients.KeywordsHeart FailureNatriuretic PeptideHeart Failure PatientAtrial Natriuretic PeptideAcute Heart FailureThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.