Molecular Biomarkers of Cardiovascular Disease in Non-human Great Apes:A Scoping Review

Background: Cardiovascular disease (CVD) is a leading cause of mortality among captive non-human great apes, including chimpanzees (Pan troglodytes), bonobos (Pan paniscus), gorillas (Gorilla spp.), and orangutans (Pongo spp.) (1). CVD in these species frequently presents as idiopathic myocardial fibrosis (IMF), often resulting in sudden cardiac death without prior clinical signs, limiting opportunities for antemortem diagnosis and intervention. Methods: A scoping review was conducted following PRISMA-ScR guidelines. Searches of CAB Abstracts, MEDLINE, Web of Science, and Zoological Record identified peer-reviewed studies investigating molecular biomarkers associated with CVD in captive great apes. Results: Sixteen studies met the inclusion criteria, including ten cross-sectional studies. Most research was conducted in North America and Europe and focused on chimpanzees. No eligible studies were identified for orangutans. Biomarkers investigated included natriuretic peptides, cardiac troponins, metabolic and inflammatory markers, allostatic load indices, and fibrosis-associated markers. Conclusion: No specific biomarker currently demonstrates sufficient evidence for reliable antemortem diagnosis of CVD in great apes in human care. A multi-biomarker approach may offer greater diagnostic utility. Future research should prioritise longitudinal studies with confirmed cardiac outcomes, standardised cardiac phenotyping, species-specific reference ranges and assessment of novel fibrosis-associated biomarkers to improve antemortem detection and management of IMF in great apes.