title: Biomarkers of diastolic dysfunction and myocardial fibrosis: application to heart failure with a preserved ejection fraction.
abstract: Comprehensive diagnostic criteria, accurate prognostic indicators, and effective treatment for patients with heart failure and a preserved ejection fraction (HFpEF) represent a critically important unmet need in cardiovascular medicine. Novel approaches to fill this unmet need are likely to be facilitated by targeting the underlying and unique pathophysiologic mechanisms that characterize patients with HFpEF. Two possible targets include hemodynamic overload evidenced by increased LV diastolic pressure (LVDP) and myocardial fibrosis evidenced by increased extracellular matrix fibrillar collagen. The measurement of LVDP and fibrosis generally requires either invasive procedures and/or complex and sophisticated imaging techniques. However, biomarkers measured in the plasma have been shown to accurately reflect changes in hemodynamic load and myocardial fibrosis and may have important application to the management of patients with HFpEF. The purpose of this review is to describe current and future applications of biomarkers in the management of patients with HFpEF.
authors.affiliation: Division of Cardiology, Department of Medicine, Medical University of South Carolina and Ralph H. Johnson, Ashley River Towers, 25 Courtenay Drive, Charleston, SC 29425, USA. zilem@musc.edu
authors.forename: Michael R
authors.initials: MR
authors.lastname: Zile
authors.forename: Catalin F
authors.initials: CF
authors.lastname: Baicu
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D024022:Fibrillar Collagens / Q000032:analysis*; D005355:Fibrosis; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D009206:Myocardium / Q000737:chemistry* / Q000473:pathology; D045265:Natriuretic Peptides / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D024022:Fibrillar Collagens; D045265:Natriuretic Peptides