Abstract
Heart failure (HF) is a complex clinical syndrome with a huge social burden in terms of cost, morbidity, and mortality. Brain natriuretic peptide (BNP) appears to be the gold standard in supporting the daily clinical management of patients with HF. Novel biomarkers may supplement BNP to improve the understanding of this complex disease process and, possibly, to personalize care for the different phenotypes, in order to ameliorate prognosis. In this review, we will examine some of the most promising novel biomarkers in HF. Inflammation plays a pivotal role in the genesis and progression of HF and, therefore, several candidate molecules have been investigated in recent years for diagnosis, prognosis, and therapy monitoring. Noncoding RNAs are attractive as biomarkers and their potential clinical applications may be feasible in the era of personalized medicine. Given the complex pathophysiology of HF, it is reasonable to expect that the future of biomarkers lies in the application of precision medicine, through wider testing panels and “omics” technologies, to further improve HF care delivery.
Highlights
Heart failure (HF) has emerged as a growing and significant public health issue due to its epidemic prevalence, to the high rate of morbidity—requiring hospitalization and intensive care—and mortality; approximately 17.9 million people each year die for cardiovascular disease and 9.6% is attributed to heart failure [1]
Myocardial fibrosis occurs when the production of type I and type II collagen exceeds its degradation and this can lead to two types of fibrosis: a macroscopic replacement fibrosis, which is typical of the post-ischemic scar, and a microscopic, diffuse, reactive fibrosis, involving the interstitial and perivascular space
The first long non-coding RNA (lncRNA) identified as a potential biomarker of HF is LIPCAR, a mitochondria-derived lncRNA found in the plasma of patients with maladaptive LV remodelling after myocardial infarction (MI)
Summary
Heart failure (HF) has emerged as a growing and significant public health issue due to its epidemic prevalence, to the high rate of morbidity—requiring hospitalization and intensive care—and mortality; approximately 17.9 million people each year die for cardiovascular disease and 9.6% is attributed to heart failure [1]. Precise and replicated assessment must be cost-effective and promptly accessible; it must add potential and significant medical information that is not already available from a conscientious clinical evaluation; and, the variety of possible clinical applications of its measurement may enhance the care of patients [2,3]. All these strict criteria are fulfilled by just a few biomarkers, but new different biomarkers may be able to add new pathophysiological insight elucidating clinical scenarios and to guide the precise treatment in HF patients
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