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Biomarkers to Predict Reverse Remodeling and Myocardial Recovery in Heart Failure

  • Biomarkers of Heart Failure (W H W Tang, Section Editor)
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Abstract

Left ventricular remodeling appears to be a critical link between cardiac injury and the development and progression of heart failure with reduced ejection fraction (HFrEF). Several drug and device therapies that modify and reverse the remodeling process in patients with HFrEF are closely associated with improvement in clinical outcomes. Reverse remodeling, including partial or complete recovery of systolic function and structure, is possible but its determinants are incompletely understood. Methods to predict reverse remodeling in response to therapy are not well defined. Though non-invasive imaging techniques remain the most widely used methods of assessing reverse remodeling, serum biomarkers are now being investigated as more specific, mechanistically driven, and clinically useful predictors of reverse remodeling. Biomarkers that reflect myocyte stretch and stress, myocyte injury and necrosis, inflammation and fibrosis, and extracellular matrix turnover may be particularly valuable for predicting pathophysiologic changes and prognosis in individual patients. Their use may ultimately allow improved application of precision medicine in chronic HF.

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Acknowledgments

Dr. Gaggin is supported in part by the Clark Fund for Cardiac Research Innovation.

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Authors and Affiliations

  1. Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Shweta R. Motiwala

  2. Division of Cardiology, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5B, Boston, MA, 02114, USA

    Hanna K. Gaggin

  3. Harvard Medical School, Boston, MA, USA

    Hanna K. Gaggin

  4. Harvard Clinical Research Institute, Boston, MA, USA

    Hanna K. Gaggin

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  1. Shweta R. Motiwala
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Correspondence to Hanna K. Gaggin.

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Conflict of Interest

Hanna K. Gaggin reports the following disclosures: 1) Roche Diagnostics: research grant, consultancy; 2) Portola: research grant; 3) Amgen: consultancy; 4) American Regent: consultancy; 5) Boston Heart Diagnostics: consultancy; 6) Critical Diagnostics: consultancy; 7) Ortho Clinical: consultancy; 8) EchoSense, Radiometer: clinical endpoint committee.

Dr. Motiwala does not have any disclosures.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Biomarkers of Heart Failure

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Motiwala, S.R., Gaggin, H.K. Biomarkers to Predict Reverse Remodeling and Myocardial Recovery in Heart Failure. Curr Heart Fail Rep 13, 207–218 (2016). https://doi.org/10.1007/s11897-016-0303-y

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