Rilevanza clinica e interpretazione dei marcatori biochimici nello scompenso cardiaco

Clinical relevance and interpretation of biochemical markers in heart failure. Heart failure (HF) is a global problem with an estimated prevalence of 38 million patients worldwide. Both prevalence and incidence of HF increase progressively with population ageing (prevalence ≥10% in people >75 years), especially in the high-income countries. HF is considered as the fatal event of all cardiovascular disorders. Despite some progress in diagnosis and treatment, its prognosis is worse than that of most cancers. The disease is heterogeneous in its clinical presentation and the diagnosis is not based on a single test, but on a combination of the history, physical examination and appropriate investigations, including some laboratory tests. As a consequence, the accuracy of diagnosis by clinical signs alone is often inadequate, especially in the early asymptomatic stage of HF. For these reasons, there is an increasing interest in the development of new biomarkers useful for the diagnosis, prognosis and follow-up of patients with HF. The aim of this paper is to provide an overview of biomarkers recommended by international guidelines for HF, discussing their clinical impact and the interpretation of results. Furthermore, a possible strategy for the development and evaluation of novel prognostic biomarkers for HF will be suggested