Biomarkers and diagnostics in heart failure
TL;DR: Novel biomarkers show potential in determining prognosis beyond the established natriuretic peptides, but their role in the clinical care of the patient is still partially defined and more studies are needed.
About: This article is published in Biochimica et Biophysica Acta.The article was published on 2013-12-01 and is currently open access. It has received 307 citations till now. The article focuses on the topics: Natriuretic peptide & Atrial natriuretic peptide.
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01 Jan 2009
TL;DR: To measure BNP levels in Patients with congestive heart disease, to use the BNP in the heart failure treatment and Routine use of BNP assays may help to more rapidly identify patients with heart failure, thereby saving money on unnecessary echocardiograms.
Abstract: The present study was undertaken to identify the congestive heart failure patients by BNP test. To measure BNP levels in Patients with congestive heart disease, to use the BNP in the heart failure treatment and Routine use of BNP assays may help to more rapidly identify patients with heart failure, thereby saving money on unnecessary echocardiograms. In the present study observe the measurement of B-type natriuretic peptide in the heart failure patients. Heart failure, also called congestive heart failure, is a automated rapid assays have been made available condition in which the heart cannot pump enough to hospital laboratories, an increasing number of oxygenated blood to meet the needs of the body's other studies that were performed by clinical investigators organs. The heart keeps pumping, but not as efficiently as have documented the usefulness of these markers in the a healthy heart. Usually, the loss in the heart's pumping process of diagnosis, prognosis and treatment of cardiac action is a symptom of an underlying heart problem. Heart disease (5). failure affects nearly 35 million adults in world total The present study was undertaken to identify the population (1). It is on the rise with an estimated 4 congestive heart failure patients by BNP test.To measure to7 millions new cases each year. More than 7.5 million BNP levels in Patients with congestive heart disease , to Indian's suffer from CHF and nearly a million new use the BNP in the heart failure treatment and Routine use cases arise each year. Congestive heart failure (CHF), of BNP assays may help to more rapidly identify patients congestive cardiac failure (CCF) or just heart failure is a with heart failure, thereby saving money on unnecessary condition that can result from any structural or functional echocardiograms. cardiac disorder that impairs the ability of the heart to fill with or pump a sufficient amount of blood through the
583 citations
TL;DR: This review article provides a general overview of types of HF pathogenesis and diagnostic features of HF including the crucial role of exercise in determining the severity of heart failure, the efficacy of therapeutic strategies and the morbidity/mortality of HF.
Abstract: Despite the advancement in medicine, management of heart failure (HF), which usually presents as a disease syndrome, has been a challenge to healthcare providers. This is reflected by the relatively higher rate of readmissions along with increased mortality and morbidity associated with HF. In this review article, we first provide a general overview of types of HF pathogenesis and diagnostic features of HF including the crucial role of exercise in determining the severity of heart failure, the efficacy of therapeutic strategies and the morbidity/mortality of HF. We then discuss the quality control measures to prevent the growing readmission rates for HF. We also attempt to elucidate published and ongoing clinical trials for HF in an effort to evaluate the standard and novel therapeutic approaches, including stem cell and gene therapies, to reduce the morbidity and mortality. Finally, we discuss the appropriate utilization/documentation and medical coding based on the severity of the HF alone and with minor and major co-morbidities. We consider that this review provides an extensive overview of the HF in terms of disease pathophysiology, management and documentation for the general readers, as well as for the clinicians/physicians/hospitalists.
258 citations
TL;DR: The interaction between cardiac fibrosis, cardiomyocyte hypertrophy and cell death, and potential strategies for tackling progressive cardiac remodeling and HF are described.
Abstract: Cardiac stress can induce morphological, structural and functional changes of the heart, referred to as cardiac remodeling. Myocardial infarction or sustained overload as a result of pathological causes such as hypertension or valve insufficiency may result in progressive remodeling and finally lead to heart failure (HF). Whereas pathological and physiological (exercise, pregnancy) overload both stimulate cardiomyocyte growth (hypertrophy), only pathological remodeling is characterized by increased deposition of extracellular matrix proteins, termed fibrosis, and loss of cardiomyocytes by necrosis, apoptosis and/or phagocytosis. HF is strongly associated with age, and cardiomyocyte loss and fibrosis are typical signs of the aging heart. Fibrosis results in stiffening of the heart, conductivity problems and reduced oxygen diffusion, and is associated with diminished ventricular function and arrhythmias. As a consequence, the workload of cardiomyocytes in the fibrotic heart is further augmented, whereas the physiological environment is becoming less favorable. This causes additional cardiomyocyte death and replacement of lost cardiomyocytes by fibrotic material, generating a vicious cycle of further decline of cardiac function. Breaking this fibrosis-cell death axis could halt further pathological and age-related cardiac regression and potentially reverse remodeling. In this review, we will describe the interaction between cardiac fibrosis, cardiomyocyte hypertrophy and cell death, and discuss potential strategies for tackling progressive cardiac remodeling and HF.
192 citations
TL;DR: This review will discuss natriuretic peptides and the more novel biomarkers by dividing them into categories based on the major pathophysiologic pathways they represent and the future of biomarker testing lies in the application of multimarker testing panels, precision medicine to improveHF care delivery, and the use of biomarkers in proteomics and metabolomics to further improve HF care.
Abstract: Heart failure (HF) is a complex syndrome with an enormous societal burden in terms of cost, morbidity, and mortality. Natriuretic peptide testing is now widely used to support diagnosis, prognostication, and management of patients with HF and are incorporated into HF clinical practice guidelines. Beyond the natriuretic peptides, 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. In this review, we will discuss natriuretic peptides and the more novel biomarkers by dividing them into categories based on the major pathophysiologic pathways they represent. Given the complex physiology in HF, it is reasonable to expect that the future of biomarker testing lies in the application of multimarker testing panels, precision medicine to improve HF care delivery, and the use of biomarkers in proteomics and metabolomics to further improve HF care.
173 citations
TL;DR: This review will examine how evidence generated from the mepolizumab clinical development program showed that blood eosinophil counts evolved as a pharmacodynamic and predictive biomarker for the efficacy of treatment with mepolIZumab in patients with severe eOSinophilic asthma.
Abstract: The last decade has seen the approval of several new biologics for the treatment of severe asthma-targeting specific endotypes and phenotypes. This review will examine how evidence generated from the mepolizumab clinical development program showed that blood eosinophil counts, rather than sputum or tissue eosinophil counts, evolved as a pharmacodynamic and predictive biomarker for the efficacy of treatment with mepolizumab in patients with severe eosinophilic asthma. Based on the available evidence and combined with clinical judgement, a baseline blood eosinophil threshold of 150 cells/μL or greater or a historical blood eosinophil threshold of 300 cells/μL or greater will allow selection of patients with severe eosinophilic asthma who are most likely to achieve clinically significant reductions in the rate of exacerbations with mepolizumab treatment.
165 citations
Cites background from "Biomarkers and diagnostics in heart..."
...In the case of heart failure, the presence of increased concentrations of B-type natriuretic peptide, which is produced in response to myocardial stress, has both positive and negative diagnostic value.(28) B-type natriuretic peptide concentration on admission to the hospital also has a linear relationship with morbidity and mortality outcomes and is the gold standard prognostic biomarker for heart failure....
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...B-type natriuretic peptide concentration on admission to the hospital also has a linear relationship with morbidity and mortality outcomes and is the gold standard prognostic biomarker for heart failure.(28) In the case of asthma, early observations on the association between eosinophil overexpression and asthma severity were made in 1990 by Bousquet et al....
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References
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TL;DR: In this article, Anderson et al. proposed a new FAHA Chair, Jeffrey L. Anderson, MD, FACC, FAHA, Chair-Elect, Alice K. Jacobs et al., this article and Biykem Bozkurt.
11,386 citations
TL;DR: Authors/Task Force Members: John J. McMurray (Chairperson) (UK), Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Angelo Auricchio (Switzerland), Michael Böhm ( Germany), Kenneth Dickstein (Norway), Volkmar Falk (Sw Switzerland), Gerasimos Filippatos (G Greece), Cândida Fonseca (Portugal), Miguel Angel Gomez-Sanchez (Spain).
Abstract: Authors/Task Force Members: John J.V. McMurray (Chairperson) (UK)*, Stamatis Adamopoulos (Greece), Stefan D. Anker (Germany), Angelo Auricchio (Switzerland), Michael Böhm (Germany), Kenneth Dickstein (Norway), Volkmar Falk (Switzerland), Gerasimos Filippatos (Greece), Cândida Fonseca (Portugal), Miguel Angel Gomez-Sanchez (Spain), Tiny Jaarsma (Sweden), Lars Køber (Denmark), Gregory Y.H. Lip (UK), Aldo Pietro Maggioni (Italy), Alexander Parkhomenko (Ukraine), Burkert M. Pieske (Austria), Bogdan A. Popescu (Romania), Per K. Rønnevik (Norway), Frans H. Rutten (The Netherlands), Juerg Schwitter (Switzerland), Petar Seferovic (Serbia), Janina Stepinska (Poland), Pedro T. Trindade (Switzerland), Adriaan A. Voors (The Netherlands), Faiez Zannad (France), Andreas Zeiher (Germany).
6,367 citations
TL;DR: The Statistical Update brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update each year.
Abstract: Appendix I: List of Statistical Fact Sheets. URL: http://www.americanheart.org/presenter.jhtml?identifier=2007
We wish to thank Drs Brian Eigel and Michael Wolz for their valuable comments and contributions. We would like to acknowledge Tim Anderson and Tom Schneider for their editorial contributions and Karen Modesitt for her administrative assistance.
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# Summary {#article-title-2}
Each year, the American Heart Association, in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on disease …
6,176 citations
"Biomarkers and diagnostics in heart..." refers background in this paper
...Currently an estimated 5.8 million people in the United States [1] and 23 million people worldwide [2] are living with HF....
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...8 million people in the United States [1] and 23 million people worldwide [2] are living with HF....
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TL;DR: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure have been developed in collaboration with the Heart Failure Association (HFA) of the ESC 2012 Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 as mentioned in this paper.
Abstract: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012 : The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC
5,841 citations
TL;DR: The past history, and likely future of this important topic has been/will remain more “evolution” than “big-bang”, and the current redefinition was flawed at inception owing to a fundamental problem with the troponin assays available at that time.
Abstract: Myocardial infarction is a major cause of death and disability worldwide. Coronary atherosclerosis is a chronic disease with stable and unstable periods. During unstable periods with activated inflammation in the vascular wall, patients may develop a myocardial infarction. Myocardial infarction may be a minor event in a lifelong chronic disease, it may even go undetected, but it may also be a major catastrophic event leading to sudden death or severe hemodynamic deterioration. A myocardial infarction may be the first manifestation of coronary artery disease, or it may occur, repeatedly, in patients with established disease. Information on myocardial infarction attack rates can provide useful data regarding the burden of coronary artery disease within and across populations, especially if standardized data are collected in a manner that demonstrates the distinction between incident and recurrent events. From the epidemiological point of view, the incidence of myocardial infarction in a population can be used as a proxy for the prevalence of coronary artery disease in that population. Furthermore, the term myocardial infarction has major psychological and legal implications for the individual and society. It is an indicator of one of the leading health problems in the world, and it is an outcome measure in clinical trials and observational studies. With these perspectives, myocardial infarction may be defined from a number of different clinical, electrocardiographic, biochemical, imaging, and pathological characteristics.
In the past, a general consensus existed for the clinical syndrome designated as myocardial infarction. In studies of disease prevalence, the World Health Organization (WHO) defined myocardial infarction from symptoms, ECG abnormalities, and enzymes. However, the development of more sensitive and specific serological biomarkers and precise imaging techniques allows detection of ever smaller amounts of myocardial necrosis. Accordingly, current clinical practice, health care delivery systems, as well as epidemiology and clinical trials all require a …
3,774 citations