Key result
A multimarker model combining hemodynamic and mechanical stress markers provides a comprehensive approach for diagnosing and prognosticating heart failure with preserved LVEF in older adults.
Why the study?
Diagnosing heart failure with preserved LVEF in elderly patients is challenging due to the low specificity of clinical manifestations and age-related involutive processes.
A multimarker approach combining hemodynamic and mechanical stress markers may improve the diagnosis and prognosis of heart failure with preserved ejection fraction in older adults.
Biochemical markers may aid HFpEF diagnosis in elderly; leaves open validation in prospective cohorts before clinical use.
The search for reliable algorithms for diagnosing heart failure with preserved left ventricular ejection fraction (LVEF) in elderly patients is an urgent problem due to the low specificity of clinical manifestations and the peculiarities of involutive processes occurring in the human body. As an alternative diagnostic approach, it is possible to determine in the blood laboratory biochemical markers — a promising method of diagnosis, prognosis and control of the effectiveness of treatment. The article examines the significance of myocardial stress markers (brain natriuretic peptide, N-terminal brain natriuretic peptide, median fragment of atrial natriuretic peptide); «mechanical» myocardial stress (soluble stimulating growth factor expressed by gene 2 — sST2), copeptin, galectin-3 in patients with heart failure and preserved LVEF, including older persons, as well as the possibility of their use in outpatient practice to predict the course of heart failure. The contribution of the multimarker model for a comprehensive assessment of prognosis is discussed, taking into account both the «hemodynamic» side of myocardial stress (pressure or volume overload, markers — natriuretic peptides), and «mechanical» (fibrosis / hypertrophy / heart remodeling, marker — sST2) myocardial changes.
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Larina et al. (2021) conducted a review in Heart failure with preserved left ventricular ejection fraction (HFpEF). Biomarkers (natriuretic peptides, sST2, copeptin, galectin-3) was evaluated. A multimarker model combining hemodynamic and mechanical stress markers provides a comprehensive approach for diagnosing and prognosticating heart failure with preserved LVEF in older adults.
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