Is it time for the practical application of biomarkers in chronic heart failure management?

Chronic heart failure is a complex clinical syndrome with increasing significance in the ageing societies of developed countries. Recent advances in both medical and instrumental therapy improve the prognosis of heart failure patients which, nevertheless, remains poor. Patients suffer from progressive pump failure reflected in increasing incidence of hospital admissions as well as sudden death due to electrical imbalance of diseased myocardium.

Aim: The aim of the study was to review of current data on some most promising heart failure biomarkers.

Materials and methods: To realize the aim of the work we analyzed papers published in recent years in medical journals indexed in PubMed and Google Scholar.

Results: Currently, only natriuretic peptides, reflecting pressure overload of the heart, and cardiac troponins, are recognized and used in practice diagnostic biomarkers of heart failure. Numerous plasma substances are being studied such as: galectin-3, ST-2 protein, MR-proADM, GDF- 15, uric acid and other. Among them, especially cardiac interstitial fibrosis markers seem to have the biggest prognostic value in heart failure patients.

Conclusions: There is a growing number of indices with scientifically proven association with clinical outcome of heart failure patients. Large, randomized trials investigating the impact of biomarkers-guided clinical decisions on patients outcome are certainly needed.