Beyond Natriuretic Peptides for Diagnosis and Management of Heart Failure.


Journal Article (Review)

BACKGROUND: Heart failure (HF) is a complex syndrome with an enormous societal burden in terms of cost and morbidity and mortality. Natriuretic peptide (NP) testing is now widely used to support diagnosis, prognostication, and management of patients with HF, but NPs come with limitations, including vulnerability to the presence of obesity, atrial fibrillation, and renal dysfunction, for example. Beyond the NPs, novel biomarkers may supplement traditional clinical and laboratory testing to improve understanding of the complex disease process of HF, and possibly to personalize care for those affected through better individual phenotyping. CONTENT: In this review we discuss novel biomarkers by dividing them into categories based on major pathophysiologic pathways they represent including myocardial stretch/stress, cardiac extracellular matrix remodeling, cardiomyocyte injury/death, oxidative stress, inflammation, neurohumoral activation, and renal dysfunction. SUMMARY: Given the limitations of NPs, along with the complex physiology in HF, it is logical to consider utilization of novel biomarkers providing orthogonal biological and clinical information. Several novel HF biomarkers have shown promise but have substantial expectations to meet before being used clinically. Nonetheless, it is reasonable to expect the future lies in the application of multibiomarker panels for the improvement in management of HF and the personalization of care.

Full Text

Duke Authors

Cited Authors

  • Ibrahim, NE; Januzzi, JL

Published Date

  • January 2017

Published In

Volume / Issue

  • 63 / 1

Start / End Page

  • 211 - 222

PubMed ID

  • 28062619

Pubmed Central ID

  • 28062619

Electronic International Standard Serial Number (EISSN)

  • 1530-8561

Digital Object Identifier (DOI)

  • 10.1373/clinchem.2016.259564


  • eng

Conference Location

  • England