ABSTRACT

Introduction: Despite advances in medical care, heart failure (HF)-associated morbidity and mortality remains high. Consequently, there is increased effort to find better ways for predicting, screening, and prognosticating HF in order to facilitate effective primary and secondary prevention.

Areas covered: In this review, we describe the various biomarkers associated with different etiologic pathways implicated in HF, and discuss their roles in screening, diagnosing, prognosticating and predicting HF. We explore the emerging role of multi-omic approaches. We performed electronic searches in databases (PubMed and Google Scholar) through December 2020, using the following key terms: biomarker, novel, heart failure, risk, prediction, and estimation.

Circulating BNP and troponin concentrations have been established in clinical care as key biomarkers for diagnosing and prognosticating HF. Emerging biomarkers (such as galectin-3 and ST-2) have gained further recognition for use in evaluating prognosis of HF patients. Promising biomarkers that are yet to be part of clinical recommendations include biomarkers of cardiorenal disease.

Expert opinion: Increasing recognition of the complex and interdependent nature of pathophysiological pathways of HF has led to the application of multi-marker approaches including multi-omic high throughput assays. These newer approaches have the potential for new therapeutic discoveries and improving precision medicine in HF.

摘要

简介：尽管医疗保健取得了进步，但与心力衰竭 (HF) 相关的发病率和死亡率仍然很高。因此，人们越来越努力寻找预测、筛查和预后 HF 的更好方法，以促进有效的一级和二级预防。

涵盖的领域：在这篇综述中，我们描述了与 HF 相关的不同病因学途径相关的各种生物标志物，并讨论了它们在筛查、诊断、预后和预测 HF 中的作用。我们探索了多组学方法的新兴作用。截至 2020 年 12 月，我们使用以下关键术语在数据库（PubMed 和谷歌学术搜索）中进行了电子搜索：生物标志物、小说、心力衰竭、风险、预测和估计。

循环 BNP 和肌钙蛋白浓度已在临床护理中确定为诊断和预测 HF 的关键生物标志物。新兴的生物标志物（如半乳糖凝集素 3 和 ST-2）在评估心衰患者的预后方面得到了进一步认可。尚未成为临床推荐的一部分的有前途的生物标志物包括心肾疾病的生物标志物。

专家意见：人们越来越认识到 HF 病理生理学途径的复杂性和相互依赖性，导致应用多标记方法，包括多组学高通量分析。这些更新的方法有可能发现新的治疗方法并改进 HF 的精准医疗。