2. Biomarkers

The definition of biomarker is as follows: biomarkers are parameters which can be measured objectively and assessed as an indicator of normal biologic or pathogenic process or response to treatment. An ideal biomarker should have the capability of reflecting the pathway centrally important to the disease under investigation, thereby providing therapeutic insights. An ideal biomarker should have three important characteristics: (1) It should be measured in a short time with low cost. (2) It should add complementary information to clinical evaluation. (3) It should aid to the treatment of HF. Biomarkers with these characteristics can be used for confirming the presence or absence of HF syndrome, for finding the specific underlying cause of HF, assessing the severity and prognosis of HF, and identifying patients likely to respond to specific treatments. HF does not occur as a result of a single pathophysiologic disease, but a multiple of pathophysiologic mechanisms resulting in volume and/or pressure overload. This makes the use of these biomarkers complex and difficult. Despite significant overlaps,


ALT, Alanine aminotransferase; AST, aspartate aminotransferase; BNP, brain natriuretic peptide; BUN, blood urea nitrogen; ET-1, endothelin 1; Hb, hemoglobin: Htc, hematocrit; IL-6, interleukin-6; LDH, lactate dehydrogenase; MRproADM, mid-regional proadrenomedullin; MR-proBNP, mid-regional proBNP; NT-proBNP, N-terminal proBNP; RDW, red blood cell distribution width.

Table 1. Biomarkers in heart failure.

biomarkers used in HF can be roughly arranged into four categories: (1) myocardial stress/ injury, (2) neurohormonal activation, (3) remodeling, and (4) comorbidities (Table 1).
