title: Emerging biomarkers in heart failure.
abstract: BACKGROUND
  Until recently, biomarker testing in heart failure (HF) syndromes has been viewed as an elective supplement to diagnostic evaluation of patients suspected to suffer from this condition. This approach to the use of biomarker testing contrasts with other cardiovascular diagnoses such as acute myocardial infarction, for which biomarkers are integral to disease process definition, risk stratification, and in some cases treatment decision making.
  
  
  BACKGROUND
  In this review we consider various perspectives on the evaluation of biomarkers in HF. In addition, we examine recent advances in the understanding of established biomarkers in HF (such as the natriuretic peptides), the elucidation of novel biomarkers potentially useful for the evaluation and management of patients with HF, and the growing understanding of important and relevant comorbidities in HF. We also review candidate biomarkers from a number of classes: (a) myocyte stretch, (b) myocyte necrosis, (c) systemic inflammation, (d) oxidative stress, (e) extracellular matrix turnover, (f) neurohormones, and (g) biomarkers of extracardiac processes, such as renal function.
  
  
  CONCLUSIONS
  Novel applications of established biomarkers of HF as well as elucidation and validation of emerging assays for HF syndromes have collectively led to a growing interest in the more widespread use of such testing in patients affected by the diagnosis.
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: Roland R J
authors.initials: RR
authors.lastname: van Kimmenade
authors.forename: James L
authors.initials: JL
authors.lastname: Januzzi
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D005109:Extracellular Matrix / Q000378:metabolism; D055436:Growth Differentiation Factor 15 / Q000032:analysis; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D000072179:Interleukin-1 Receptor-Like 1 Protein; D032383:Myocytes, Cardiac / Q000473:pathology; D045265:Natriuretic Peptides / Q000032:analysis; D009336:Necrosis; D018377:Neurotransmitter Agents / Q000378:metabolism; D018384:Oxidative Stress; D011956:Receptors, Cell Surface / Q000032:analysis
chemical_list: D015415:Biomarkers; D055436:Growth Differentiation Factor 15; C079241:IL1RL1 protein, human; D018836:Inflammation Mediators; D000072179:Interleukin-1 Receptor-Like 1 Protein; D045265:Natriuretic Peptides; D018377:Neurotransmitter Agents; D011956:Receptors, Cell Surface