Biomarkers in acute heart failure.
The care of patients with acutely decompensated heart failure is being reshaped by the availability and understanding of several novel and emerging heart failure biomarkers. The gold standard biomarkers in heart failure are B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide, which play an important role in the diagnosis, prognosis, and management of acute decompensated heart failure. Novel biomarkers that are increasingly involved in the processes of myocardial injury, neurohormonal activation, and ventricular remodeling are showing promise in improving diagnosis and prognosis among patients with acute decompensated heart failure. These include midregional proatrial natriuretic peptide, soluble ST2, galectin-3, highly-sensitive troponin, and midregional proadrenomedullin. There has also been an emergence of biomarkers for evaluation of acute decompensated heart failure that assist in the differential diagnosis of dyspnea, such as procalcitonin (for identification of acute pneumonia), as well as markers that predict complications of acute decompensated heart failure, such as renal injury markers. In this article, we will review the pathophysiology and usefulness of established and emerging biomarkers for the clinical diagnosis, prognosis, and management of acute decompensated heart failure.
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States.
Aditi
A
Mallick
Cardiology Division, Institute for Heart, Vascular, and Stroke Care, Massachusetts General Hospital, Boston, Massachusetts, United States. Electronic address: jjanuzzi@partners.org.
James L
JL
Januzzi
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000175:diagnosis; D053607:Adrenomedullin / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D002116:Calcitonin / Q000378:metabolism; D037502:Galectin 3 / Q000378:metabolism; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D000072179:Interleukin-1 Receptor-Like 1 Protein; D045265:Natriuretic Peptides / Q000378:metabolism; D011498:Protein Precursors / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000378:metabolism; D014336:Troponin / Q000378:metabolism
D015415:Biomarkers; D037502:Galectin 3; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D045265:Natriuretic Peptides; D011498:Protein Precursors; D011956:Receptors, Cell Surface; D014336:Troponin; C088633:proadrenomedullin; D053607:Adrenomedullin; D002116:Calcitonin
Acute decompensated heart failure; Biomarcadores; Biomarkers; Insuficiencia cardiaca aguda descompensada