Congestion in heart failure: a circulating biomarker-based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology
Núñez, Julio; de la Espriella, Rafael; Rossignol, Patrick; Voors, Adriaan A; Mullens, Wilfried; Metra, Marco; Chioncel, Ovidiu; Januzzi, James L; Mueller, Christian; Richards, A Mark; de Boer, Rudolf A; Thum, Thomas; Arfsten, Henrike; González, Arantxa; Abdelhamid, Magdy; Adamopoulos, Stamatis; Anker, Stefan D; Gal, Tuvia Ben; Biegus, Jan; Cohen-Solal, Alain; Böhm, Michael; Emdin, Michele; Jankowska, Ewa A; Gustafsson, Finn; Hill, Loreena; Jaarsma, Tiny; Jhund, Pardeep S; Lopatin, Yuri; Lund, Lars H; Milicic, Davor; Moura, Brenda; Piepoli, Massimo F; Ponikowski, Piotr; Rakisheva, Amina; Ristic, Arsen; Savarese, Gianluigi; Tocchetti, Carlo G; Van Linthout, Sophie; Volterrani, Maurizio; Seferovic, Petar; Rosano, Giuseppe; Coats, Andrew J S; Bayes-Genis, Antoni
(2022) European Journal of Heart Failure, volume 24, issue 10, pp. 1751 - 1766
(Article)
Abstract
Congestion is a cardinal sign of heart failure (HF). In the past, it was seen as a homogeneous epiphenomenon that identified patients with advanced HF. However, current evidence shows that congestion in HF varies in quantity and distribution. This updated view advocates for a congestive-driven classification of HF according to
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onset (acute vs. chronic), regional distribution (systemic vs. pulmonary), compartment of distribution (intravascular vs. extravascular), and clinical vs. subclinical. Thus, this review will focus on the utility of circulating biomarkers for assessing and managing the different fluid overload phenotypes. This discussion focused on the clinical utility of the natriuretic peptides, carbohydrate antigen 125 (also called mucin 16), bio-adrenomedullin and mid-regional pro-adrenomedullin, ST2 (also known as interleukin-1 receptor-like 1), cluster of differentiation 146, troponin, C-terminal pro-endothelin-1, and parameters of haemoconcentration. The utility of circulation biomarkers on top of clinical evaluation, haemodynamics, and imaging needs to be better determined by dedicated studies. Some multiparametric frameworks in which these tools contribute to management are proposed.
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Keywords: Adrenomedullin, Biomarkers, Cardiology, Heart Failure/diagnosis, Humans, Prognosis, Acute heart failure, Congestion, Cardiology and Cardiovascular Medicine, Review, Research Support, Non-U.S. Gov't, Journal Article
ISSN: 1388-9842
Publisher: Oxford University Press
Note: Funding Information: This work was supported by grants from the Ministry of Economy and Competitiveness, Instituto Carlos III (PI20/00392), CIBER Cardiovascular (16/11/00420 and 16/11/00403). Funding Information: : J.N. reports personal fees from AstraZeneca, Novartis, Boehringer Ingelheim, Eli Lilly, Rovi, NovoNordisk, and Vifor Pharma (outside the submitted work). R.d.l.E. reports personal fees from AstraZeneca, Novartis, Boehringer Ingelheim, and NovoNordisk (outside the submitted work). P.R. reports consulting for Bayer, CinCor, G3P, Idorsia, and KBP; honoraria from Ablative Solutions, AstraZeneca, Bayer, Boehringer Ingelheim, Corvidia, CVRx, Fresenius, Novartis, Novo Nordisk, Relypsa Inc., a Vifor Pharma Group Company, Roche, Sanofi, Sequana Medical, Servier, and Vifor Fresenius Medical Care Renal Pharma; Cofounder: CardioRenal, a company developing potassium and creatinine sensors for home monitoring. A.A.V. has received consultancy fees and/or research grants from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Merck, Myokardia, Novartis, Novo Nordisk, and Roche Diagnostics. W.M. has received research grants from Novartis, Vifor, Medtronic, Biotronik, Abbott, and Boston Scientific. M.M. and O.C. report grants from Servier, Vifor and Novartis and other from Boehringer Ingelheim. J.L.J. is a Trustee of the American College of Cardiology, a board member of Imbria Pharmaceuticals, has received grant support from Applied Therapeutics, Innolife, Novartis Pharmaceuticals and Abbott Diagnostics, consulting income from Abbott, Janssen, Novartis, and Roche Diagnostics, and participates in clinical endpoint committees/data safety monitoring boards for Abbott, AbbVie, Amgen, Bayer, CVRx, Janssen, MyoKardia and Takeda. C.M. has received research support from the Swiss National Science Foundation, the Swiss Heart Foundation, the KTI, the University Hospital Basel, the University of Basel, Abbott, Astra Zeneca, Beckman Coulter, Brahms, Idorsia, Novartis, LSI Medience Corporation, Ortho Clinical Diagnostics, Quidel, Roche, Siemens, Singulex, Sphingotec, all outside the current work, as well as speaker honoraria/consulting honoraria from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Idorsia, Novartis, Osler, Roche, Sanofi, and Singulex, all outside the current work and paid to the institution. A.M.R. reports research grants, advisory board fees and/or speakers honoraria/travel costs from AstraZeneca, NovoNordisk, Roche Diagnostics, Abbott Laboratories, Thermo Fisher, Critical Diagnostics, Novartis, Pfizer, Bayer, Medtronic, Boston Scientific, Sphingotec, and MiRXES. R.A.d.B. received speaker fees from Abbott, AstraZeneca, Bayer, Novartis, and Roche (outside the submitted the work). The UMCG, which employs Dr. de Boer has received research grants and/or fees from AstraZeneca, Abbott, Boehringer Ingelheim, Cardior Pharmaceuticals Gmbh, Ionis Pharmaceuticals, Inc., NovoNordisk, and Roche (outside the submitted work). S.D.A. reports receiving fees from Abbott, Actimed, Bayer, Boehringer Ingelheim, Cardiac Dimension, Cordio, Impulse Dynamics, Novartis, Occlutech, Servier, and Vifor Pharma, and grant support from Abbott and Vifor Pharma. A.C.S. received fees or grants from Bayer, Merck, AstraZeneca, Boehringer Ingelheim, Abbott, Novartis, We‐Health, Sanofi, and Vifor Pharma. M.B. is supported by the Deutsche Forschungsgemeinschaft (German Research Foundation; TTR 219, project number 322900939) and reports personal fees from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Medtronic, Novartis, Servier and Vifor. E.A.J. reports grants and personal fees from Vifor Pharma, personal fees from Bayer, Novartis, Abbott, Boehringer Ingelheim, Pfizer, Servier, AstraZeneca, Berlin Chemie, Cardiac Dimensions, Respicardia, Takeda, Swixx Biopharma, Gedeon Richter, Radcliffe Group, Translational Medicine Academy, outside the submitted work. F.G. is an advisor to Pfizer, Ionis, Alnylam, Bayer, Pharmacosmos and Abbott; received speaker honoraria from Novartis, Orion Pharma, AstraZeneca, Vifor Pharma and Boehringer Ingelheim. P.S.J. employer the University of Glasgow has received payment from Novartis, AstraZeneca, NovoNordisk and Bayer for work on clinical trials, research support from Boehringer Ingelheim and Analog Devices Inc and speakers and advisory board fees from AstraZeneca, Novartis and Boehringer Ingelheim. L.H.L. reports grants, consulting fees and/or speaker's honoraria from Myocardia, AstraZeneca, Roche, Boehringer Ingelheim, Novartis, Bayer, Vifor, Sanofi, Servier, Abbott, Pharmacosmos, Medscape, Radcliffe, TMA, Orion Pharma, and stock ownership in AnaCardio, all outside the submitted work. B.M. reports personal fees and/or advisory board from AstraZeneca, Novartis, Boehringer Ingelheim, Eli‐Lilly, Servier, and Vifor Pharma. P.P. reports fees from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Corida, Cytokinetics, Impulse Dynamics, Novartis, Radcliffe, Servier, Vifor, all outside the current work. G.S. reports grants and personal fees from Vifor, AstraZeneca, grants from Boehringer Ingelheim, Novartis, Boston Scientific, Pharmacosmos, Merck, Bayer, personal fees from Società Prodotti Antibiotici, Roche, Servier, GENESIS, Cytokinetics, Medtronic, Teva, TMA, outside the submitted work. C.G.T. received funding from Amgen and personal fees from VivaLyfe, and is listed as an inventor on two heart failure patents. A.B.G. reports personal fees and/or advisory board from AstraZeneca, Novartis, Boehringer Ingelheim, Abbott, Roche Diagnostics, and Vifor Pharma. All other authors have nothing to disclose. Conflict of interest Publisher Copyright: © 2022 European Society of Cardiology.
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