Emerging Biomarkers in Heart Failure

heart failure (HF) syndromes has been viewed as an elective supplement to diagnostic evaluation of pa-tients suspected to suffer from this condition. This ap-proach to the use of biomarker testing contrasts with other cardiovascular diagnoses such as acute myocar-dial infarction, for which biomarkers are integral to disease process definition, risk stratification, and in some cases treatment decision making. CONTENT: In this review we consider various perspec-tives on the evaluation of biomarkers in HF. In addi-tion, we examine recent advances in the understanding of established biomarkers inHF (such as the natriuretic peptides), the elucidation of novel biomarkers poten-tially useful for the evaluation and management of pa-tients with HF, and the growing understanding of im-portant and relevant comorbidities in HF. We also review candidate biomarkers from a number of classes: (a) myocyte stretch, (b) myocyte necrosis, (c) systemic inflammation, (d) oxidative stress, (e) extracellular matrix turnover, (f) neurohormones, and (g) biomark-ers of extracardiac processes, such as renal function. SUMMARY: Novel applications of established biomark-ers of HF as well as elucidation and validation of emerging assays forHF syndromes have collectively led to a growing interest in the more widespread use of such testing in patients affected by the diagnosis