THE IMPORTANCE OF BIOMARKERS IN THE MANAGEMENT OF PATIENTS WITH HEART FAILURE AND PRESERVED EJECTION FRACTION
Abstract:
Patients with heart failure (HF) can be divided into those with heart failure and a reduced
ejection fraction (HFrEF) and those with heart failure and a preserved ejection fraction (HFpEF). In the
presence of compromised systolic function, appropriate signs and symptoms make it relatively easy to
set the diagnosis of heart failure. However, because of the nonspecific nature of clinical findings,
especially the symptoms of heart failure, when left ventricle (LV) systolic functions normally, the
diagnosis becomes more difficult. Efficient diagnosis and optimal therapy remain challenging in this
population. Imaging, electrocardiographic, and circulating biomarkers, as well as pharmacogenetics,
may help facilitating HF diagnosis, stratifying the risk, and individualizing the therapy. Biomarkers
reflect myocyte stress, myocyte injury, renal function, systemic inflammation and fibrosis have
contributed to better understanding the pathophysiologic mechanisms relevant to HFpEF, and may
eventually help facilitating more effective and personalized management of this syndrome. Biomarkers
include proteins, peptides, and microRNAs that can be measured in the plasma and can be shown to
represent changes in myocardial structure or function that reflect underlying pathophysiologic
processes.(1) In this article, we present the biomarkers that cause changes in hemodynamic and fibrosis
in patients with HFpEF: natriuretic peptides, markers of extracellular matrix turnover, galectin-3,
markers of renal function, cardiac troponins, ST2, growth differentiation factor (GDF-15), microRNAs
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