Measurement of multiple biomarkers in advanced stage heart failure patients treated with pulmonary artery catheter guided therapy

30 adults (age ≥21 years) with advanced stage NYHA Class IV heart failure due to LV systolic dysfunction (median LVEF 21%) admitted to the Cardiac ICU for treatment guided by pulmonary artery catheter (PAC) monitoring. Median age 57, 77% male, US-based (single center). Key inclusion: decompensated HF manifesting as CVP >8 mmHg, PCWP >16 mmHg, SVR >1200 dyn-sec/cm5, or cardiac index <2 L/minute.

Measurement of multiple biomarkers (sST2, NT-proBNP, hsTnI, eTnI, cys-C, MPO) twice daily over the first 48 hours of ICU admission, with clinical management guided by pulmonary artery catheter (PAC) monitoring.

Failure to achieve individual goals for specific hemodynamic variables (CVP <8 mm Hg, PCWP <16 mm Hg, and SVR <1200 dyn-sec/cm5) as part of PAC guided HF management within 48 hours after ICU admission, PAC removal or ICU discharge.surrogate