• DOI:10.1373/CLINCHEM.2003.027557
• Corpus ID: 13034623

Strategies for developing biomarkers of heart failure.

@article{Jortani2004StrategiesFD,
  title={Strategies for developing biomarkers of heart failure.},
  author={Saeed A. Jortani and Sumanth D. Prabhu and Roland Jr. Valdes},
  journal={Clinical chemistry},
  year={2004},
  volume={50 2},
  pages={
          265-78
        }
}

• S. Jortani, S. Prabhu, R. Valdes
• Published 1 February 2004
• Medicine, Biology
• Clinical chemistry

BACKGROUND
Heart failure (HF) is a devastating disease with increasing prevalence in elderly populations. One-half of all patients die within 5 years of diagnosis. The annual cost of treating patients with HF in the US is more than $20 billion, which is estimated to be greater than that of myocardial infarction and all cancers combined. Given the complex pathophysiology and varied manifestations of HF, interest has intensified in developing biological markers to predict susceptibility and aid in the early diagnosis and management of this disease.

METHODS
We searched Medline via Ovid for studies published during the period 1966-2003 regarding various biomarkers suggested for HF. Our review focused on developing strategies for discovering and using new biomarkers, particularly those potentially linked to pathophysiologic mechanisms. We also point out strategic advantages, limitations, and methods available for measuring each of the currently proposed markers.

RESULTS
Biomarkers reviewed include those released from the heart during normal homeostasis (natriuretic peptides), those produced elsewhere that act on the heart (endogenous cardiotonic steroids and other hormones), and those released in response to tissue damage (inflammatory cytokines). The concept of using a combination of multiple markers based on diagnosis, prognosis, and acute vs chronic disease is also discussed. In view of recent advances in our understanding of molecular biochemical derangements observed during cardiac failure, we consider the concept of myocardial remodeling and the heart as part of an endocrine system as strategies.

CONCLUSION
Strategically, biomarkers linked to mechanisms involved in the etiology of HF, such as dysregulation of ion transport, seem best suited for serving as early biological markers to predict and diagnose disease, select therapy, or assess progression.