Do Heart Failure Biomarkers Influence Heart Failure Treatment Response?

Heart failure (HF) is one of the leading causes of cardiac disease, death, and poor quality of life, and impacts approximately 26 million people worldwide. The frequency and seriousness of this condition emphasizes the importance of quick and accurate diagnosis, management, and treatment of HF.

Emerging understanding about the cellular and molecular pathways of HF has precipitated the study of biomarkers (signifiers within the body that measure the presence of a biological process or condition), which are increasingly becoming a vital clinical tool in the diagnosis and prognostication of HF. In a recently published review in Current Heart Failure Reports, researchers provide an overview of the current HF biomarker landscape and highlight a number of novel biomarkers that could potentially impact HF treatment strategies. 

The authors explain that although many studies have examined the clinical usage of multiple HF biomarkers, B-type natriuretic peptide (BNP, a hormone in the blood) and N-terminal proBNP (NT-proBNP, an inactive protein released alongside BNP) remain the gold standard for diagnosis, prognosis, and risk stratification of HF. They further highlight the current lack of well-developed recommendations for the usage of biomarkers in HF therapy, which may, in part, be due to the continued evolution of pharmacologic therapy options, new insights into HF pathophysiology, and increasingly  complex patients with multiple diseases. Although these factors may present interfering variables when determining the effectiveness of biomarkers in guided therapy, the authors emphasize that continued research in this area is important for future advancements in personalized care and biomarker-guided HF therapy.

“The goal is ultimately to have either single or panels of biomarkers that can be tested easily in practice, and each of these biomarkers requires robust validation to understand what they mean for a patient’s care, when to test them, and how to use them,” says study co-author Dr. Justin Ezekowitz. “This level of validity exists for only a few biomarkers in the area of HF.” 

This research was co-authored by Dr. Tiffany Yeun (Cardiology Resident, University of Alberta), CVC trainees Dr. Pishoy Gouda (Interventional Cardiology Fellow) and Robert Margaryan (MSc student), and CVC Co-Director Dr. Justin Ezekowitz.