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 J. de la Espriella R. Rossignol P. Voors A.A. Mullens W. Metra M. Chioncel O. Januzzi J.L. Mueller C. Richards A.M. de Boer R.A. Thum T. Arfsten H. González A. Abdelhamid M. Adamopoulos S. Anker S.D. Gal T.B. Biegus J. Cohen-Solal A. Böhm M. Emdin M. Jankowska E.A. Gustafsson F. Hill L. Jaarsma T. Jhund P.S. Lopatin Y. Lund L.H. Milicic D. Moura B. Piepoli M.F. Ponikowski P. Rakisheva A. Ristic A. Savarese G. Tocchetti C.G. Van Linthout S. Volterrani M. Seferovic P. Rosano G. Coats A.J.S. Bayes-Genis A.
October 2022John Wiley and Sons Ltd
European Journal of Heart Failure
2022#24Issue 101751 - 1766 pp.
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 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.
Acute heart failure , Biomarkers , Congestion
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Hospital Clínico Universitario de Valencia, INCLIVA, Universidad de Valencia, Valencia, Spain
CIBER Cardiovascular, Madrid, Spain
Université de Lorraine, INSERM, Centre dInvestigations Cliniques-Plurithématique 14-33, INSERM U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
Department of Cardiology University Medical Center Groningen, University of Groningen, Groningen, Netherlands
Hospital Oost-Limburg, Genk, Belgium
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Cardiology. ASST Spedali Civili, University of Brescia, Brescia, Italy
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’, University of Medicine Carol Davila, Bucharest, Romania
Massachusetts General Hospital and Baim Institute for Clinical Research, Boston, MA, United States
Department of Cardiology, University Hospital, Basel, Switzerland
Cardiovascular Research Institute, National University of Singapore, Singapore, Singapore
Christchurch Heart Institute, University of Otago, Dunedin, New Zealand
Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and Rebirth Center for Translational Regenerative Therapies, Hannover Medical School, Hannover, Germany
Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany
Clinical Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
German Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany
Program of Cardiovascular Diseases, CIMA Universidad de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
Faculty of Medicine, Cairo University, Giza, Egypt
2nd Department of Cardiovascular Medicine, Onassis Cardiac Surgery Center, Athens, Greece
Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
Cardiology Department, Rabin Medical Center, Petah Tikva, Israel
Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
Inserm 942 MASCOT, Université de Paris, AP-HP, Hopital Lariboisière, Paris, France
Universitätsklinikum des Saarlandes, Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin Homburg/Saar, Saarland University, Saarbrücken, Germany
Institute of Life Sciences, Scuola Superiore SantAnna, Pisa, Italy
Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
Rigshospitalet-Copenhagen University Hospital, Heart Centre, Department of Cardiology, Copenhagen, Denmark
Queens University Belfast, Belfast, United Kingdom
Linkoping University, Linkoping, Sweden
BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom
Volgograd State Medical University, Volgograd, Russian Federation
Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
University of Zagreb, School of Medicine, Zagreb, Croatia
Faculty of Medicine, University of Porto, Porto, Portugal
Cardiology Department, Porto Armed Forces Hospital, Porto, Portugal
Cardiology Division, Castel San Giovanni Hospital, Castel San Giovanni, Italy
Scientific Research Institute of Cardiology and Internal Medicine, Almaty, Kazakhstan
School of Medicine, University of Belgrade, Belgrade, Serbia
Cardio-Oncology Unit, Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research (CISI), Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy
Berlin Institute of Health (BIH) at Charité-Universitätmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
IRCCS San Raffaele, Rome, Italy
Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Serbian Academy of Sciences and Arts, Belgrade, Serbia
St. Georges Hospitals NHS Trust University of London, London, United Kingdom
University of Warwick, Coventry, United Kingdom
Institut del Cor, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
Hospital Clínico Universitario de Valencia
CIBER Cardiovascular
Université de Lorraine
Department of Cardiology University Medical Center Groningen
Hospital Oost-Limburg
Department of Medical and Surgical Specialties
Emergency Institute for Cardiovascular Diseases ‘Prof. C.C. Iliescu’
Massachusetts General Hospital and Baim Institute for Clinical Research
Department of Cardiology
Cardiovascular Research Institute
Christchurch Heart Institute
Institute of Molecular and Translational Therapeutic Strategies (IMTTS) and Rebirth Center for Translational Regenerative Therapies
Fraunhofer Institute of Toxicology and Experimental Medicine
Clinical Division of Cardiology
German Centre for Cardiovascular Research (DZHK)
Program of Cardiovascular Diseases
Faculty of Medicine
2nd Department of Cardiovascular Medicine
Department of Cardiology (CVK); and Berlin Institute of Health Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin
Cardiology Department
Institute of Heart Diseases
Inserm 942 MASCOT
Universitätsklinikum des Saarlandes
Institute of Life Sciences
Cardiology Division
Rigshospitalet-Copenhagen University Hospital
Queens University Belfast
Linkoping University
BHF Glasgow Cardiovascular Research Centre
Volgograd State Medical University
Department of Medicine
University of Zagreb
Faculty of Medicine
Cardiology Department
Cardiology Division
Scientific Research Institute of Cardiology and Internal Medicine
School of Medicine
Cardio-Oncology Unit
Berlin Institute of Health (BIH) at Charité-Universitätmedizin Berlin
IRCCS San Raffaele
Faculty of Medicine
Serbian Academy of Sciences and Arts
St. Georges Hospitals NHS Trust University of London
University of Warwick
Institut del Cor
Department of Medicine
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