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Novel Biomarkers of Subclinical Cardiac Dysfunction in the General Population

  • Biomarkers of Heart Failure (W.H.W. Tang and J.L. Grodin, Section Editors)
  • Published:
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Abstract

Purpose of Review

Recognition of subclinical myocardial dysfunction offers clinicians and patients an opportunity for early intervention and prevention of symptomatic cardiovascular disease. We review the data on novel biomarkers in subclinical heart disease in the general population with a focus on pathophysiology, recent observational or trial data, and potential applicability and pitfalls for clinical use.

Recent Findings

High-sensitivity cardiac troponin and natriuretic peptide assays are powerful markers of subclinical cardiac disease. Elevated levels of these biomarkers signify subclinical cardiac injury and hemodynamic stress and portend an adverse prognosis. Novel biomarkers of myocardial inflammation, fibrosis, and abnormal contraction are gaining momentum as predictors for incident heart failure, providing new insight into pathophysiologic mechanisms of cardiac disease.

Summary

There has been exciting growth in both traditional and novel biomarkers of subclinical cardiac injury in recent years. Many biomarkers have demonstrated associations with relevant cardiovascular outcomes and may enhance the diagnostic and prognostic power of more conventional biomarkers. However, their use in “prime time” to identify patients with or at risk for subclinical cardiac dysfunction in the general population remains an open question. Strategic investigation into their clinical applicability in the context of clinical trials remains an area of ongoing investigation.

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Abbreviations

CVD:

Cardiovascular disease

DHS:

Dallas Heart Study

HF:

Heart failure

H-FABP:

Heart-associated fatty acid binding peptides

hs-cTnT:

High-sensitivity cardiac troponin T

IGF:

Insulin-like growth factor

LVH:

Left ventricular hypertrophy

MMPs:

Matrix metalloproteinases

MYPT1-P/T:

Myosin light chain phosphatase 1 activity

NT-proBNP:

N-terminal pro-B-type natriuretic peptide

OPG:

Osteoprotegerin

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Author notes

  1. Kamal Shemisa, Anish Bhatt, and Daniel Cheeran contributed equally to this article.

Authors and Affiliations

  1. Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8830, USA

    Kamal Shemisa, Anish Bhatt, Daniel Cheeran & Ian J. Neeland

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  1. Kamal Shemisa
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  2. Anish Bhatt
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  3. Daniel Cheeran
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  4. Ian J. Neeland
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Correspondence to Ian J. Neeland.

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Conflict of Interest

Kamal Shemisa, Anish Bhatt, and Daniel Cheeran declare no conflicts of interest.

Ian J. Neeland is supported by grant K23 DK106520 from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institute of Health and by the Dedman Family Scholarship in Clinical Care from UT Southwestern.

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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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Shemisa, K., Bhatt, A., Cheeran, D. et al. Novel Biomarkers of Subclinical Cardiac Dysfunction in the General Population. Curr Heart Fail Rep 14, 301–310 (2017). https://doi.org/10.1007/s11897-017-0342-z

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