Advancing Risk Stratification in HFpEF: Unveiling the Potential of Cardiac Fibrosis Markers for Early Diagnosis and Enhanced Patient Outcomes

Heart failure with preserved ejection fraction (HFpEF) challenges clinicians due to its diverse presentation and limitations in traditional diagnostic criteria. This study delves into the potential of cardiac fibrosis markers like galectin-3, NT-proBNP, and trimethylamine N-oxide (TMAO) to enhance diagnostic precision and patient outcomes in HFpEF. A systematic review of sixteen relevant studies revealed that these biomarkers offer promise for early detection and improved risk assessment. For instance, TMAO indicates systemic implications of HFpEF, while galectin-3 shows predictive value across heart failure types. Additionally, machine-learning models incorporating multiple biomarkers predict significant risk of adverse outcomes. Despite these advances, challenges like biomarker standardization and validation persist, highlighting the need for comprehensive risk assessment strategies. This study underscores the importance of these markers in addressing critical gaps in HFpEF care and calls for their integration into routine clinical practice.