Abstract
Heart failure is a class of cardiovascular diseases that remains the number one cause of death worldwide with a substantial economic burden of around $18 billion incurred by the healthcare sector in 2017 due to heart failure hospitalization and disease management. Although several laboratory tests have been used for early detection of heart failure, these traditional diagnostic methods still fail to effectively guide clinical decisions, prognosis, and therapy in a timely and cost-effective manner. Recent advances in the design and development of biosensors coupled with the discovery of new clinically relevant cardiac biomarkers are paving the way for breakthroughs in heart failure management. Natriuretic neurohormone peptides, B-type natriuretic peptide (BNP) and N-terminal prohormone of BNP (NT-proBNP), are among the most promising biomarkers for clinical use. Remarkably, they result in an increased diagnostic accuracy of around 80% owing to the strong correlation between their circulating concentrations and different heart failure events. The latter has encouraged research towards developing and optimizing BNP biosensors for rapid and highly sensitive detection in the scope of point-of-care testing. This review sheds light on the advances in BNP and NT-proBNP sensing technologies for point-of-care (POC) applications and highlights the challenges of potential integration of these technologies in the clinic. Optical and electrochemical immunosensors are currently used for BNP sensing. The performance metrics of these biosensors—expressed in terms of sensitivity, selectivity, reproducibility, and other criteria—are compared to those of traditional diagnostic techniques, and the clinical applicability of these biosensors is assessed for their potential integration in point-of-care diagnostic platforms.
Highlights
Cardiovascular diseases (CVDs)—diseases of the heart and blood vessels—remain the most prevalent causes of death worldwide accounting for 31% of recorded annual mortalities [1].According to the World Health Organization, cardiovascular diseases include heart failure, rheumatic heart disease, arrhythmia, coronary heart disease, atherosclerosis, atrial fibrillation and cerebrovascular disease [1]
This allowed for the dependence on cardiac biomarkers, most importantly B-type natriuretic peptide (BNP), in orienting clinical decisions and imposed a pressing need to revolutionize biosensing for rapid point-of-care applications in the emergency room
This review presented the latest trends in BNP sensing using both optical and electrochemical transducers
Summary
Cardiovascular diseases (CVDs)—diseases of the heart and blood vessels—remain the most prevalent causes of death worldwide accounting for 31% of recorded annual mortalities [1]. While physicians often rely on electrocardiogram (ECG) measurements for diagnosis, these measurements usually fail to delineate HF-related irregularities or warning signs [8,9] To overcome these limitations to successful patient care and risk stratification, research has shifted focus to getting an in-depth understanding of disease pathogenesis at the cellular or molecular levels by monitoring the concentrations of cardiac biomarkers secreted in the blood [10,11,12]. The reviewed techniques are compared in terms of reproducibility, selectivity, sensitivity, time for delivering response, type of surface functionalization, type of sample used, and other criteria Based on the latter characteristics of the biosensing techniques, the paper presents key challenges towards achieving POCT-based BNP and NT-proBNP sensing, and it suggests future directions of research
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