Circulating biomarkers in patients with heart failure and preserved ejection fraction

Curr Heart Fail Rep. 2013 Dec;10(4):350-8. doi: 10.1007/s11897-013-0160-x.

Abstract

Patients with heart failure with preserved ejection fraction (HF-PEF) comprise a growing proportion of the overall HF burden. The pathophysiology of HF-PEF is complex, and relates to the interplay between cardiac risk factors (notably diabetes/insulin resistance, hypertension), systemic inflammation, and comorbid medical illness (e.g. chronic kidney disease) that conspire to promote endothelial dysfunction, ventricular-vascular stiffening, and diastolic dysfunction. Efficient diagnosis and optimal therapy remain challenging in this population. Imaging, electrocardiographic, and circulating biomarkers, as well as pharmacogenetics, may help to facilitate HF diagnosis, stratify risk, and individualize therapy. In this review, we focus on established and emerging circulating biomarkers in HF-PE, including circulating biomarkers of myocyte stress, myocyte injury, renal function, systemic inflammation, and fibrosis. Such markers have contributed to better understanding of the pathophysiologic mechanisms relevant to HF-PEF, and may eventually help to facilitate more effective and personalized management of this syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / blood*
  • Extracellular Matrix / metabolism
  • Growth Differentiation Factor 15 / blood
  • Heart Failure / diagnosis*
  • Heart Failure / physiopathology
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein
  • Kidney / physiopathology
  • Natriuretic Peptides / blood
  • Receptors, Cell Surface / blood
  • Stroke Volume / physiology*
  • Troponin / blood

Substances

  • Biomarkers
  • GDF15 protein, human
  • Growth Differentiation Factor 15
  • IL1RL1 protein, human
  • Interleukin-1 Receptor-Like 1 Protein
  • Natriuretic Peptides
  • Receptors, Cell Surface
  • Troponin