CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE

Biomarkers (various laboratory biochemical markers), such as natriuretic peptides (NP), soluble ST2 receptor, copeptin, galectin-3, are widely studied in patients with chronic heart failure (CHF). The European Society of Cardiology recommends the determination of blood NP level in suspicion of HF an...

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Main Authors: A. M. Aliyeva, E. V. Reznik, E. T. Hasanova, I. V. Zhbanov, I. G. Nikitin
Format: Article
Language:Russian
Published: SINAPS LLC 2018-10-01
Series:Архивъ внутренней медицины
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Online Access:https://www.medarhive.ru/jour/article/view/835
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author A. M. Aliyeva
E. V. Reznik
E. T. Hasanova
I. V. Zhbanov
I. G. Nikitin
author_facet A. M. Aliyeva
E. V. Reznik
E. T. Hasanova
I. V. Zhbanov
I. G. Nikitin
author_sort A. M. Aliyeva
collection DOAJ
description Biomarkers (various laboratory biochemical markers), such as natriuretic peptides (NP), soluble ST2 receptor, copeptin, galectin-3, are widely studied in patients with chronic heart failure (CHF). The European Society of Cardiology recommends the determination of blood NP level in suspicion of HF and its use as one of the mandatory diagnostic criteria for CHF with preserved and mid-range ejection fraction. Dynamics of NP concentration may be predictor of the effectiveness of the therapy and the necessity of the titration of the dose of HF drugs. Neprilyzin destroys NP, but does not destroy their precursors, including NT-proBNP. Therefore, it is necessary to use NT-proBNP as a marker of therapeutic efficacy and prognosis when using neprilysine inhibitors (sacubitril). ST2 is a protein receptor for interleukin-33 (IL-33). The transmembrane ST2 (ST2L) binds to IL-33 and forms the IL-33/ST2L complex, which has a cardioprotective effect, prevents the development of myocardial hypertrophy, fibrosis and apoptosis. The soluble ST2 receptor (sST2) is a “trap” for IL-33 and neutralizes the protective effects of the IL-33/ST2L complex, which leads to hypertrophy and fibrosis of the myocardium, dilatation of the chambers and reduction of the contractility of the heart. It can be considered as a marker of unfavorable prognosis in heart failure, but it is not specific. Copeptin is a part of the arginine-vasopressin, or antidiuretic hormone, precursor which plays an important role in the pathogenesis of CHF. Since arginine-vasopressin has a short half-life and is unstable outside the body, copeptin is being actively investigated. Its level increases during the CHF decompensation and relates with the functional class of CHF. A combined measurement of the concentration of copeptin and NP may improve the risk stratification in CHF patients. Galectin-3 is a peptide that stimulates the activation of fibroblasts and the development of fibrosis. It increases in CHF patients and is associated with the severity of the condition, systolic and diastolic LV dysfunction and prognosis. Currently, NP are the best biomarkers that can and should be used in routine clinical practice. To prove the need for widespread use of other biomarkers, additional research is needed.
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spelling doaj-art-8622ea3bf00f4579901ac53ce3ef060b2025-08-20T04:00:03ZrusSINAPS LLCАрхивъ внутренней медицины2226-67042411-65642018-10-018533334510.20514/2226-6704-2018-8-5-333-345694CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILUREA. M. Aliyeva0E. V. Reznik1E. T. Hasanova2I. V. Zhbanov3I. G. Nikitin4Department of Hospital Therapy № 2 of the Faculty of Medicine of the Federal State Educational Institution Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation.Department of Hospital Therapy № 2 of the Faculty of Medicine of the Federal State Educational Institution Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation.Department of Hospital Therapy № 2 of the Faculty of Medicine of the Federal State Educational Institution Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation.Federal State Scientific Institution «Russian Scientific Center for Surgery named after Academician B.V. Petrovsky».Department of Hospital Therapy № 2 of the Faculty of Medicine of the Federal State Educational Institution Russian National Research Medical University named after N.I. Pirogov of the Ministry of Health of the Russian Federation.Biomarkers (various laboratory biochemical markers), such as natriuretic peptides (NP), soluble ST2 receptor, copeptin, galectin-3, are widely studied in patients with chronic heart failure (CHF). The European Society of Cardiology recommends the determination of blood NP level in suspicion of HF and its use as one of the mandatory diagnostic criteria for CHF with preserved and mid-range ejection fraction. Dynamics of NP concentration may be predictor of the effectiveness of the therapy and the necessity of the titration of the dose of HF drugs. Neprilyzin destroys NP, but does not destroy their precursors, including NT-proBNP. Therefore, it is necessary to use NT-proBNP as a marker of therapeutic efficacy and prognosis when using neprilysine inhibitors (sacubitril). ST2 is a protein receptor for interleukin-33 (IL-33). The transmembrane ST2 (ST2L) binds to IL-33 and forms the IL-33/ST2L complex, which has a cardioprotective effect, prevents the development of myocardial hypertrophy, fibrosis and apoptosis. The soluble ST2 receptor (sST2) is a “trap” for IL-33 and neutralizes the protective effects of the IL-33/ST2L complex, which leads to hypertrophy and fibrosis of the myocardium, dilatation of the chambers and reduction of the contractility of the heart. It can be considered as a marker of unfavorable prognosis in heart failure, but it is not specific. Copeptin is a part of the arginine-vasopressin, or antidiuretic hormone, precursor which plays an important role in the pathogenesis of CHF. Since arginine-vasopressin has a short half-life and is unstable outside the body, copeptin is being actively investigated. Its level increases during the CHF decompensation and relates with the functional class of CHF. A combined measurement of the concentration of copeptin and NP may improve the risk stratification in CHF patients. Galectin-3 is a peptide that stimulates the activation of fibroblasts and the development of fibrosis. It increases in CHF patients and is associated with the severity of the condition, systolic and diastolic LV dysfunction and prognosis. Currently, NP are the best biomarkers that can and should be used in routine clinical practice. To prove the need for widespread use of other biomarkers, additional research is needed.https://www.medarhive.ru/jour/article/view/835chronic heart failurebiomarkersbiochemical blood testmyocardial infarctionnatriuretic peptidesbrain natriuretic peptident-probnpsoluble st2 receptorcopeptingalectin-3prognosisrisk stratificationdiagnosistreatmentmanagement
spellingShingle A. M. Aliyeva
E. V. Reznik
E. T. Hasanova
I. V. Zhbanov
I. G. Nikitin
CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE
Архивъ внутренней медицины
chronic heart failure
biomarkers
biochemical blood test
myocardial infarction
natriuretic peptides
brain natriuretic peptide
nt-probnp
soluble st2 receptor
copeptin
galectin-3
prognosis
risk stratification
diagnosis
treatment
management
title CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE
title_full CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE
title_fullStr CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE
title_full_unstemmed CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE
title_short CLINICAL VALUE OF BLOOD BIOMARKERS IN PATIENTS WITH CHRONIC HEART FAILURE
title_sort clinical value of blood biomarkers in patients with chronic heart failure
topic chronic heart failure
biomarkers
biochemical blood test
myocardial infarction
natriuretic peptides
brain natriuretic peptide
nt-probnp
soluble st2 receptor
copeptin
galectin-3
prognosis
risk stratification
diagnosis
treatment
management
url https://www.medarhive.ru/jour/article/view/835
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