title: Clinical Application of Biomarkers in Heart Failure with a Preserved Ejection Fraction: A Review.
abstract: Heart failure with a preserved ejection fraction (HFpEF) is increasingly prevalent and a leading cause of morbidity and mortality worldwide. HFpEF has a complex pathophysiology, with recent evidence suggesting that an interaction of cardiovascular and noncardiovascular comorbidities (e.g. obesity, hypertension, diabetes, coronary artery disease, and chronic kidney disease) induces an inflammatory state that eventually leads to myocardial structural and functional alterations. Current ACCF/AHA guidelines suggest incorporation of biomarkers along with clinical and imaging tools to establish the diagnosis and disease severity in heart failure (HF). However, the majority of data on biomarkers relating to their levels, or their role in accurate diagnosis, prognostication, and disease activity, has been derived from studies in undifferentiated HF or HF with a reduced EF (HFrEF). As the understanding of the mechanisms underlying HFpEF continues to evolve, biomarkers reflecting different pathways including neurohormonal activation, myocardial injury, inflammation, and fibrosis have a clinical utility beyond the diagnostic scope. Accordingly, in this review article we describe the various established and novel plasma biomarkers and their emerging value in diagnosis, prognosis, response, and guiding of targeted therapy in patients with HFpEF.
authors: Department of Medicine, Saint Peter's University Hospital, New Brunswick, N.J., USA.
authors: Aakash
authors: A
authors: Garg
authors: Deepti
authors: D
authors: Virmani
authors: Sahil
authors: S
authors: Agrawal
authors: Chirag
authors: C
authors: Agarwal
authors: Abhishek
authors: A
authors: Sharma
authors: Giulio
authors: G
authors: Stefanini
authors: John B
authors: JB
authors: Kostis
mesh_terms: D015415:Biomarkers / Q000097:blood*; D015897:Comorbidity; D037502:Galectin 3 / Q000097:blood; D055436:Growth Differentiation Factor 15 / Q000097:blood; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D045265:Natriuretic Peptides / Q000097:blood; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume / Q000502:physiology*; D020107:Troponin T / Q000097:blood
chemical_list: D015415:Biomarkers; C526140:GDF15 protein, human; D037502:Galectin 3; D055436:Growth Differentiation Factor 15; D045265:Natriuretic Peptides; D020107:Troponin T