Early detection of myocardial dysfunction and heart failure.
The impact of cardiac dysfunction and heart failure is continuing to escalate in the developed world. Treatment of this heterogeneous condition has focused on the symptomatic stage, often after irreversible remodeling and functional impairment have occurred. Early identification of cardiac dysfunction would allow implementation of early intervention strategies to delay the progression or to prevent the onset of heart failure altogether. Although screening methods for asymptomatic cardiac dysfunction have yet to be optimized, a staged approach for patients with predisposing risk factors using serological biomarkers followed by noninvasive imaging techniques may be useful. Existing biomarkers for cardiac dysfunction include B-type natriuretic peptide, troponins, and C-reactive protein. Novel markers such as protein ST2, galectin-3, and various prohormones are emerging and may provide prognostic information that is incremental to conventional clinical evaluation. Monitoring myocardial mechanics and molecular processes through three-dimensional speckle tracking and hybrid imaging modalities, such as PET-CT, may provide insight into disease manifestation before overt structural and physiological abnormalities.
de Couto
Geoffrey
G
Toronto General Hospital, University Health Network, NCSB 11-1266, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada.
Ouzounian
Maral
M
Liu
Peter P
PP
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein; D018450:Disease Progression; D037502:Galectin 3; D006331:Heart Diseases / Q000175:diagnosis / Q000473:pathology; D006333:Heart Failure / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D009206:Myocardium / Q000473:pathology*; D020097:Natriuretic Peptide, Brain; D049268:Positron-Emission Tomography; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014336:Troponin
D015415:Biomarkers; D037502:Galectin 3; D014336:Troponin; D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein
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