Novel Applications of Cardiac Biomarkers in Heart Failure

Novel Applications of Cardiac Biomarkers in Heart Failure

Uthamalingam Shanmugam, Januzzi James L
US Cardiology - Volume 6 - Issue I
Published: May 2009
download article View ebook

| More
dots

Abstract
Cardiac biomarkers, both established and emerging ones, have various novel applications in heart failure. The role of established biomarkers such as natriuretic peptides—both B-type natriuretic peptide (BNP) and N-terminal prohormone brain natriuretic peptide (NT-proBNP)—in acute heart failure has been well studied. The role of natriuretic peptides in the primary care setting and utilization of natriuretic peptides along with clinical evaluation in the treatment of patients with chronic heart failure are promising. In addition, other markers such as cardiac-specific troponins or C-reactive protein (CRP), as well as more emerging markers of matrix remodeling such as matrix metalloproteinases, tissue inhibitors of metalloproteinases, galectin-3, and ST2, may have a role not only for prognostication of patients with heart failure but also in the optimal management of these patients.

Keywords
Biomarkers, natriuretic peptides, BNP, NT-proBNP, novel cardiac biomarkers, galectin-3, ST2

Disclosure: James J Januzzi, Jr, MD, FACC, receives grant support, speaking fees, and/or consulting income from Roche Diagnostics, Siemens Diagnostics, Critical Diagnostics, BG Medicine, and Inverness Diagnostics. Shanmugam Uthamalingam, MD, has no conflicts of interest to declare.
Received: January 31, 2009 Accepted: February 26, 2009
Correspondence: James L Januzzi, Jr, MD, FACC, Massachusetts General Hospital, 32 Fruit Street, Yawkey 5984, Boston, MA 02114. E: jjanuzzi@partners.org

Several cardiac biomarkers may aid in the diagnostic and prognostic evaluation of acute and chronic heart failure. In this article we discuss more novel and emerging applications of such established cardiac biomarkers in heart failure and review emerging data for several other promising markers.

Novel Applications of Established Cardiac Biomarkers—Natriuretic Peptides
B-type natriuretic peptide (BNP) and its amino-terminal cleavage equivalent N-terminal prohormone brain natriuretic peptide (NT-proBNP) originate from a pre-proBNP hormone of 134 residues that is cleaved to yield a 108 amino acid intracellular pro-hormone, proBNP108; from proBNP108, BNP and NT-proBNP are liberated in varying amounts.1 The utility of BNP and NT-proBNP for the diagnostic evaluation of suspected acute heart failure in patients presenting with acute dyspnea has been well studied and previously reviewed.2–5 Emerging applications of BNP and NT-proBNP include their application in primary care, as well as their use in better managing patients with heart disease besides acute heart failure.

To register to view full article please click here.

References:
  1. Gunning M, Ballerman BJ, Silva P, et al., Am J Physiol, 190:258:F467–72.
  2. Maisel AS, Krishnaswamy P, Nowak RM, et al., N Engl J Med, 2002;347:161–7.
  3. Maisel A, Hollander JE, Guss D, et al. J Am Coll Cardiol, 2004;44:1328–33.
  4. Januzzi JL Jr, Camargo CA, Anwaruddin S, et al., Am J Cardiol, 2005;95:948–54.
  5. Januzzi JL, van Kimmenade R, Lainchbury J, et al., Eur Heart J, 2006;27:330–37.
  6. Tang WH, Girod JP, Lee MJ, et al., Circulation, 2003;108(24):2964–6.
  7. Fuat A, Murphy JJ, Hungin AP, et al., Br J Gen Pract, 2006;56:327–33.
  8. Al-Barjas M, Nair D, Ayrton P, et al., Eur J Heart Fail, 2004;3(Suppl. 1):223.
  9. Gustafsson F, Steensgaard-Hansen F, Badskjaer J, et al., J Card Fail, 2005;(Suppl. 11):S15–20.
  10. Nielsen LS, Svanegaard J, Klitgaard NA, Egeblad H, Eur J Heart Fail, 2004;6:63–70.
  11. Zaphiriou A, Robb S, Murray-Thomas T, et al., Eur J Heart Fail, 2005;7:537–41.
  12. Hildebrandt P, Collinson PO, Am J Cardiol, 2008;101:25–28A.
  13. Collinson PO, Congest Heart Fail, 2006;12(2):103–7.
  14. Heidenreich PA, Gubens MA, Fonarow GC, J Am Coll Cardiol, 2004;43(6):1019–26.
  15. Wang TJ, Levy D, Benjamin EJ, et al., Ann Intern Med, 2003;138:907–16.
  16. Krishnaswamy P, Lubien E, Clopton P, et al., Am J Med, 2001;111:274–9.
  17. Vasan RS, Benjamin EJ, Larson MG, et al., JAMA, 2002;288:1252–9.
  18. Redfield MM, Rodeheffer RJ, Jacobsen SJ, et al., Circulation, 2004;109:3176–81.
  19. Galasko G, Lahiri A, Barnes SC, et al., Eur Heart J, 2005;26:2269–76.
  20. Costello-Boerrigter LC, Boerrigter G, Redfield MM, et al., J Am Coll Cardiol, 2006;47:345–53.
  21. Fonarow GC, Peacock WF, Phillips CO, et al., J Am Coll Cardiol, 2007;49(19):1943–50.
  22. Logeart D, Thabut G, Jourdain P, et al., J Am Coll Cardiol, 2004;43(4):635–41.
  23. Bayes-Genis A, Santalo-Bel M, Zapico-Muniz E, et al., Eur J Heart Fail, 2004;6:301–8.
  24. Knebel F, Schimke I, Pliet K, et al., J Card Fail, 2005; (Suppl. 11):S38–41.
  25. Bettencourt P, Azevedo A, Pimenta J, et al., Circulation, 2004;110:2168–74.
  26. Isnard R, Pousset F, Chafirovskaia O, et al., Am Heart J, 2003;146(4):729–35.
  27. Gardner RS, Ozalp F, Murday AJ, et al., Eur Heart J, 2003;24(19):1735–43.
  28. Latini R, Masson S, Anand I, et al., Eur Heart J, 2004;25:292–9.
  29. Pascual-Figal DA, Domingo M, Casas T, Eur Heart J, 2008;29(8): 1011–18.
  30. Troughton RW, Frampton CM, Yandle TG, et al., Lancet, 2000;355: 1126–30.
  31. Jourdain P, Jondeau G, Funck F, et al., J Am Coll Cardiol, 2007;49:1733–9.
  32. Lainchbury JG, Troughton RW, Frampton CM, et al., Eur J Heart Fail, 2006;8:532–8.
  33. Brunner-La Rocca HP, Buser PT, Schindler R, et al., Am Heart J, 2006;151(5):949–55.
  34. Missov E, Calzolari C, Pau B, Circulation, 1997;96:2953–8.
  35. La Vecchia L, Mezzena G, Ometto R, et al., Am J Cardiol, 1997;80:88–90.
  36. Del Carlo CH, Pereira-Barretto AC, Cassaro-Strunz C, et al. J Card Fail, 2004;10:43–8.
  37. Sakhuja R, Green S, Oestreicher EM, Clin Chem, 2007;53(3):412–20.
  38. Peacock WF IV, De Marco T, Fonarow GC, et al., N Engl J Med, 2008;358:2117–26.
  39. Hudson MP, O’Connor CM, Gattis WA, et al., Am Heart J, 2004;147: 546–52.
  40. Sato Y, Yamada T, Taniguchi R, et al. Circulation, 2001;103:369–74.
  41. Miller WL, Hartman KA, Burritt MF, Circulation, 2007;116(3):249–57.
  42. Elster SK, Braunwald E, Wood HF. Am Heart J, 1956;51:533–41.
  43. Vasan RS, Sullivan LM, Roubenoff R, et al., Circulation, 2003;107:1486–91.
  44. Anand IS, Latini R, Florea VG, et al. Circulation, 2005;112:1428–34.
  45. Rehman S, Lloyd-Jones DM, Martinez-Rumayor A, Am J Clin Pathol, 2008;130(2):305–11.
  46. Mann DL, McMurray JJ, Packer M, et al., Circulation, 2004;109(13):1594–1602.
  47. Pfeffer MA, Braunwald E, Circulation, 1990;81:1161–72.
  48. Sundström J, Evans JC, Benjamin EJ, et al., Circulation, 2004;109(23):2850–56.
  49. Kelly D, Khan SQ, Thompson M, et al., Eur Heart J, 2008; in press.
  50. Rossi A, Cicoira M, Golia G, et al., Heart, 2004;90(6):650–54.
  51. Cicoira M, Rossi A, Bonapace S, et al., J Card Fail, 2004;10(5):403–11.
  52. Sharma UC, Pokharel S, vanBrakel TJ, et al., Circulation, 2004;110:3121–8.
  53. van Kimmenade RR, Januzzi JL Jr, Ellinor PT, J Am Coll Cardiol, 2006;48(6):1217–24.
  54. Lok, Van Der Meer, Bruggink-Andre De La Porte, et al. Available at: www.spo.escardio.org/abstractbook/ presentation.aspx?id=50876
  55. Weinberg EO, Shimpo M, De Keulenaer GW, et al. Circulation, 2002;106:2961–6.
  56. Yanagisawa K, Tsukamoto T, Takagi T, Tominaga S, FEBS Lett, 1992;302:51–3.
  57. Schmitz J, Owyang A, Oldham E, et al., Immunity, 2005;23:479–90.
  58. Sanada S, Hakuno D, Higgins LJ, et al., IL-33/ST2 is a Critical Cardioprotective Fibroblastcardiomyocyte Signaling System Activated by Mechanical Overload.Paper presented at: American Heart Association Scientific Sessions; November 12–15, 2006; Chicago, IL, 2006.
  59. Januzzi JL Jr, Peacock WF, Maisel AS, et al., J Am Coll Cardiol, 2007;50:607–13.
  60. Rehman SU, Mueller T, Januzzi JL Jr, J Am Coll Cardiol, 2008;52(18):1458–65.
  61. Boisot S, Beede J, Isakson S, et al., J Card Fail, 2008;14(9):732–8.
  62. Rehman SU, Martinez-Rumayor A, Mueller T, et al., Clin Chim Acta, 2008;392(1–2):41–5.

Copyright® 2010 Business Briefings, Ltd. All rights reserved.
Touch Cardiology is for informational purposes and should not be considered medical advice, diagnosis or treatment recommendations.