Biomarkers in heart failure: Traditional and emerging indicators for prognosis DOI Creative Commons
Arnold Péter Ráduly,

László Nagy,

Beáta Bódi

и другие.

ESC Heart Failure, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 15, 2024

Biomarkers have long been of major importance in the diagnosis, prognosis, and follow-up heart failure (HF). Recently, addition to conventional biomarkers, new types biomarkers emerged that are not yet used clinical practice may later become paramount long-term management HF. The aim this Editorial is highlight latest advancements HF related published ESC Heart Failure. crucial for diagnosing, managing predicting outcome HF, which a complex condition where struggles effectively pump blood.1 These biological indicators encompass various proteins, enzymes hormones present blood or tissue samples. They provide valuable insights into underlying pathophysiological processes such as myocardial stress, inflammation neurohormonal activation. By accurately reflecting disease progression treatment response, empower healthcare providers make informed decisions on patient care, therapy adjustments probable outcomes. Given increasing prevalence essential enhancing personalized medicine approaches management.2 N-terminal pro B-type natriuretic peptide (NT-proBNP) one most prominent diagnostic including with reduced ejection fraction (HFrEF), mildly EF (HFmrEF) preserved (HFpEF) proposed by guidelines.3 Nevertheless, NT-proBNP plasma levels can be influenced factors. Although, presence symptoms, widely accepted recommendation3 sets definite cut-off value diagnosis it less clear what threshold should considered screening when asymptomatic, high-risk patients. Goyder et al. analysed results 24 studies involving more than 26 000 patients, they found testing identifies left ventricular (LV) dysfunction population sensitivity 0.87 specificity 0.84. As result, pooled cutoff was 311 pg/mL 49 BNP, optimal thresholds high risk community populations.4 In addition, meta-analysis Hendriks investigated prognostic BNP both without across multiple prospective over thousands their meta-analysis, studied 66 (38 46 patients 28 37 HF) see predictive considered. analysis SD range increase log-transformed NT-proBNP/BNP values were associated 1.7-fold increased adverse cardiac event (MACE).5 Another interesting finding research applied cardiovascular (CV) general 90th percentile healthy subjects (cut-off BNP/NT-proBNP: 31.3/106 45.5/173 men women, respectively). (As also reported previous study,4 different had adjusted gender.) study conducted Vergaro demonstrated chronic gender differences observed NT-proBNP, soluble suppression tumourigenicity 2 protein (sST-2), high-sensitive troponin T (hs-cTnT).6 findings indicated women lower MACE using sST-2 hs-cTnT markers. However, higher 1-year CV mortality hospitalization compared men. suggest considering gender-specific predict outcomes Ferrannini tested only about half despite an trend yearly test numbers during 7-year-long period starting from 2011 Swedish registry. 4000 commonly measured those worsening baseline diuretic doses, elevated rates, HFpEF patients.7 Electrolyte tightly controlled through physiological processes. Screening electrolytes routine inexpensive laboratory test, but care. Therefore, use could greatly assist clinicians daily practice. Of note, medications acting renin-angiotensin-aldosterone axis, sodium-glucose-cotransporter inhibitors (SGLT2i) diuretics affect body's electrolyte balance. Despite above confounders, potassium, sodium chloride still play role well-defined medical contexts For example, Xia how serum level trajectories survival retrospective cohort 3628 included, serial measurements changes conducted. classified participants seven groups depending as: hypo-, normo-, hypernatremia dynamics time. rapid normalization hyponatremia linked even accounting all confounding factors.8 Sarasiti involved smaller group focused admission hyponatremia. Their implicated acts predictor six-month rehospitalization.9 Along line, Lorenzo performed 874 consecutive echocardiography performed, prone follow up who normal at time control echocardiography.10 Lombardi data almost 1000 significance discharge potassium levels, specifically looking impact hyperkalaemia showed all-cause mortality, thus supported awareness binders groups.11 contrast aforementioned two electrolytes, ions generally emphasized, its important fact highly affected therapy. recently observational after acute decompensation, Seo provided evidence mortality.12 Growth differentiation factor 15 (GDF-15) included transforming growth beta superfamily. Generally, GDF-15 concentrations relatively low organs, expression increases response injury organs like liver, kidney information prognosis diseases. Wang 6322 stable angina coronary syndrome, apparent relationship between death events (cardiogenic shock, readmission because HF).13 Yin sought shed light acutely decompensated population. 380 assessed within first 48 h admission. Patients belonging tertiles (>4228 pg/mL) older, comorbidities, severe shorter (2416–4228 <2416 pg/mL). power appeared better hospitalizations (NT-proBNP, hsTnT).14 Zheng illuminated alpha-1 antitrypsin (AAT) biomarker isobaric tags relative absolute quantitation processing. Circulating AAT exhibited negative correlation LVEF significantly severity. pulmonary hypertension carries grim outlook, asking reliable predictions.15 Tumour necrosis alpha (TNF-alpha), inflammatory cytokine potentially function hypertension. Having non-invasive indicator aligns closely holds significant specific group. Sällberg identified additional TNF-alpha (LTBR, TNFRSF6B, TRAIL-R1 TRAIL-R2) serve potential factors his vulnerable population.16 Beside circulating novel anti beta-1 antibody (b1-AAB) modify receptor activity cardiomyocytes. appearance b1-AABs prognosis; however, ABs has fully clarified yet. Morbach effect 47 near quarter 8-fold rehospitalization 6-month-long follow-up.17 Uric acid known marker progressive effects uric (UA) lowering controversial. reason, Qin regarding incidence, influence xanthine oxidase inhibition. Thirty-six UA (near 1.5-fold). fact, there drugs target hyperuricemia, these do exert any death.18 Decreased haemoglobin anaemia entire spectrum. another frequently haematological parameter, mean corpuscular concentration (MCHC), indirectly serves carried Choy 1800 revealed decreased (MCHC: <330 g/L) combined renal failure.19 aspects management, systematic inclusion advance stratification decision-making None declared.

Язык: Английский

Editors' highlight picks from 2023 in ESC heart failure DOI Creative Commons
Magnus Bäck, Stephan von Haehling, Zoltán Papp

и другие.

ESC Heart Failure, Год журнала: 2024, Номер 11(3), С. 1283 - 1289

Опубликована: Фев. 26, 2024

Heart failure is a devastating syndrome affecting an increasingly high number of patients worldwide. Its aetiology and pathogenesis are complex with the involvement factors ranging from genetic material through valvular dysfunctions to numerous organs beyond entire cardiovascular system. Based on continuous efforts heart scientific community we have witnessed major advances in many related disciplines during last year. For example, epidemiological aspects-paving road for improved risk prevention-have been thoroughly analysed various geographical regions. Additionally, evidence-based approaches now allow introduction novel guideline recommended medical therapies (i.e. sodium-glucose transporter 2 inhibitors, iron supplementation) while basic translational research aim explore additional molecular targets future diagnostics medications. All above aspects addressed this article, where selection articles published ESC Failure journal 2023 highlighted. The editors confident that contributions effectively served highly relevant area

Язык: Английский

Процитировано

1
Plasma tumour necrosis factor‐alpha‐related proteins in prognosis of heart failure with pulmonary hypertension DOI Creative Commons
Adam Engel Sällberg,

Sara Helleberg,

Salaheldin Ahmed

и другие.

ESC Heart Failure, Год журнала: 2023, Номер 10(6), С. 3582 - 3591

Опубликована: Сен. 29, 2023

Patients with heart failure (HF) exhibit poor prognosis, which is further deteriorated by pulmonary hypertension (PH), negative impact on morbidity and mortality. As PH due to left HF (LHF-PH) among the most common causes of PH, there an urge according 2021 European Society Cardiology guidelines find new biomarkers that aid in prognostication this patient cohort. Given role tumour necrosis factor-alpha (TNF-α) progression, we aimed investigate prognostic value plasma proteins related TNF-α patients LHF-PH, relation haemodynamic changes following transplantation (HT).

Язык: Английский

Процитировано

3
Biomarkers in heart failure: Traditional and emerging indicators for prognosis DOI Creative Commons
Arnold Péter Ráduly,

László Nagy,

Beáta Bódi

и другие.

ESC Heart Failure, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 15, 2024

Biomarkers have long been of major importance in the diagnosis, prognosis, and follow-up heart failure (HF). Recently, addition to conventional biomarkers, new types biomarkers emerged that are not yet used clinical practice may later become paramount long-term management HF. The aim this Editorial is highlight latest advancements HF related published ESC Heart Failure. crucial for diagnosing, managing predicting outcome HF, which a complex condition where struggles effectively pump blood.1 These biological indicators encompass various proteins, enzymes hormones present blood or tissue samples. They provide valuable insights into underlying pathophysiological processes such as myocardial stress, inflammation neurohormonal activation. By accurately reflecting disease progression treatment response, empower healthcare providers make informed decisions on patient care, therapy adjustments probable outcomes. Given increasing prevalence essential enhancing personalized medicine approaches management.2 N-terminal pro B-type natriuretic peptide (NT-proBNP) one most prominent diagnostic including with reduced ejection fraction (HFrEF), mildly EF (HFmrEF) preserved (HFpEF) proposed by guidelines.3 Nevertheless, NT-proBNP plasma levels can be influenced factors. Although, presence symptoms, widely accepted recommendation3 sets definite cut-off value diagnosis it less clear what threshold should considered screening when asymptomatic, high-risk patients. Goyder et al. analysed results 24 studies involving more than 26 000 patients, they found testing identifies left ventricular (LV) dysfunction population sensitivity 0.87 specificity 0.84. As result, pooled cutoff was 311 pg/mL 49 BNP, optimal thresholds high risk community populations.4 In addition, meta-analysis Hendriks investigated prognostic BNP both without across multiple prospective over thousands their meta-analysis, studied 66 (38 46 patients 28 37 HF) see predictive considered. analysis SD range increase log-transformed NT-proBNP/BNP values were associated 1.7-fold increased adverse cardiac event (MACE).5 Another interesting finding research applied cardiovascular (CV) general 90th percentile healthy subjects (cut-off BNP/NT-proBNP: 31.3/106 45.5/173 men women, respectively). (As also reported previous study,4 different had adjusted gender.) study conducted Vergaro demonstrated chronic gender differences observed NT-proBNP, soluble suppression tumourigenicity 2 protein (sST-2), high-sensitive troponin T (hs-cTnT).6 findings indicated women lower MACE using sST-2 hs-cTnT markers. However, higher 1-year CV mortality hospitalization compared men. suggest considering gender-specific predict outcomes Ferrannini tested only about half despite an trend yearly test numbers during 7-year-long period starting from 2011 Swedish registry. 4000 commonly measured those worsening baseline diuretic doses, elevated rates, HFpEF patients.7 Electrolyte tightly controlled through physiological processes. Screening electrolytes routine inexpensive laboratory test, but care. Therefore, use could greatly assist clinicians daily practice. Of note, medications acting renin-angiotensin-aldosterone axis, sodium-glucose-cotransporter inhibitors (SGLT2i) diuretics affect body's electrolyte balance. Despite above confounders, potassium, sodium chloride still play role well-defined medical contexts For example, Xia how serum level trajectories survival retrospective cohort 3628 included, serial measurements changes conducted. classified participants seven groups depending as: hypo-, normo-, hypernatremia dynamics time. rapid normalization hyponatremia linked even accounting all confounding factors.8 Sarasiti involved smaller group focused admission hyponatremia. Their implicated acts predictor six-month rehospitalization.9 Along line, Lorenzo performed 874 consecutive echocardiography performed, prone follow up who normal at time control echocardiography.10 Lombardi data almost 1000 significance discharge potassium levels, specifically looking impact hyperkalaemia showed all-cause mortality, thus supported awareness binders groups.11 contrast aforementioned two electrolytes, ions generally emphasized, its important fact highly affected therapy. recently observational after acute decompensation, Seo provided evidence mortality.12 Growth differentiation factor 15 (GDF-15) included transforming growth beta superfamily. Generally, GDF-15 concentrations relatively low organs, expression increases response injury organs like liver, kidney information prognosis diseases. Wang 6322 stable angina coronary syndrome, apparent relationship between death events (cardiogenic shock, readmission because HF).13 Yin sought shed light acutely decompensated population. 380 assessed within first 48 h admission. Patients belonging tertiles (>4228 pg/mL) older, comorbidities, severe shorter (2416–4228 <2416 pg/mL). power appeared better hospitalizations (NT-proBNP, hsTnT).14 Zheng illuminated alpha-1 antitrypsin (AAT) biomarker isobaric tags relative absolute quantitation processing. Circulating AAT exhibited negative correlation LVEF significantly severity. pulmonary hypertension carries grim outlook, asking reliable predictions.15 Tumour necrosis alpha (TNF-alpha), inflammatory cytokine potentially function hypertension. Having non-invasive indicator aligns closely holds significant specific group. Sällberg identified additional TNF-alpha (LTBR, TNFRSF6B, TRAIL-R1 TRAIL-R2) serve potential factors his vulnerable population.16 Beside circulating novel anti beta-1 antibody (b1-AAB) modify receptor activity cardiomyocytes. appearance b1-AABs prognosis; however, ABs has fully clarified yet. Morbach effect 47 near quarter 8-fold rehospitalization 6-month-long follow-up.17 Uric acid known marker progressive effects uric (UA) lowering controversial. reason, Qin regarding incidence, influence xanthine oxidase inhibition. Thirty-six UA (near 1.5-fold). fact, there drugs target hyperuricemia, these do exert any death.18 Decreased haemoglobin anaemia entire spectrum. another frequently haematological parameter, mean corpuscular concentration (MCHC), indirectly serves carried Choy 1800 revealed decreased (MCHC: <330 g/L) combined renal failure.19 aspects management, systematic inclusion advance stratification decision-making None declared.

Язык: Английский

Процитировано

0