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Sex-based Differences in Heart Failure Biomarkers

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Abstract

Purpose of Review

Differences in HF biomarker levels by sex may be due to hormonal, genetic, and fat distribution differences. Knowledge of these differences is scarce, and it is not well established whether they may affect their usefulness in the management of HF.

Recent Findings

The different biomarker profiles in women and men have been confirmed in recent studies: in women, markers of cardiac stretch and fibrosis (NP and galectin-3) are higher, whereas in men, higher levels of markers of cardiac injury and inflammation (cTn and sST2) are found.

The use of new biomarkers, together with growing evidence that a multimarker approach can provide better risk stratification, raises the question of building models that incorporate sex-specific diagnostic criteria.

Summary

More and more research are being devoted to understanding sex-related differences in HF. The aim of this review is to review the dynamics of HF biomarkers according to sex and in different situations, to learn whether these sex differences may affect their use in the diagnosis and follow-up of HF patients.

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Abbreviations

BMI:

Body mass index

CTn:

Circulatory troponins

Gal-3:

Galectin-3

HF:

Heart failure

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

hs-Tn:

High-sensitivity troponin

NP:

Natriuretic peptide

NT-proBNP:

Amino-terminal pro-peptide fragment

sST2:

Soluble suppression of tumorgenicity 2

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Acknowledgements

This study has been funded by the Instituto de Salud Carlos III (ISCIII) through project "PI23/00293" and co-funded by the European Union. MM is supported by the Miguel Servet II program (CPII22/00013) and ARM has a Río Hortega contract [CM23/00125] funded by the Instituto de Salud Carlos III. The editors would like to thank Dr. Kai M. Eggers for handling the review of this manuscript.

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Authors and Affiliations

  1. Área del Corazón, Hospital Universitario Virgen de La Victoria, Málaga, Spain

    Ainhoa Robles-Mezcua, Nelsa González Aguado, Antonia Pilar Martin de la Rosa, Concepción Cruzado-Álvarez, Clara Jiménez Rubio, Alejandro IPérez Cabeza, Juan José Gómez-Doblas, Manuel F. Jiménez-Navarro, Mora Murri Pierri & José M. García-Pinilla

  2. Unidad de Insuficiencia Cardíaca y Cardiopatías Familiares, Cardiología. Hospital Universitario Virgen de La Victoria, Málaga, Spain

    Ainhoa Robles-Mezcua, Nelsa González Aguado, Antonia Pilar Martin de la Rosa, Concepción Cruzado-Álvarez, Clara Jiménez Rubio, Alejandro IPérez Cabeza & José M. García-Pinilla

  3. Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Málaga, Spain

    Ainhoa Robles-Mezcua, Nelsa González Aguado, Clara Jiménez Rubio, Alejandro IPérez Cabeza, Juan José Gómez-Doblas, Manuel F. Jiménez-Navarro & José M. García-Pinilla

  4. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain

    Ainhoa Robles-Mezcua, Alejandro IPérez Cabeza, Juan José Gómez-Doblas, Manuel F. Jiménez-Navarro, Mora Murri Pierri & José M. García-Pinilla

  5. Departamento de Medicina y Dermatología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain

    Juan José Gómez-Doblas & Manuel F. Jiménez-Navarro

  6. Endocrinology and Nutrition UGC, Hospital Universitario Virgen de La Victoria, Málaga, Spain

    Mora Murri Pierri & José M. García-Pinilla

  7. Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Hospital Clínico Virgen de La Victoria, Málaga, Spain

    Mora Murri Pierri

  8. CIBER Fisiopatología de La Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Málaga, Spain

    Mora Murri Pierri

Authors
  1. Ainhoa Robles-Mezcua
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  2. Nelsa González Aguado
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  3. Antonia Pilar Martin de la Rosa
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  4. Concepción Cruzado-Álvarez
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  10. José M. García-Pinilla
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All authors contributed significantly to the preparation of the manuscript. All authors reviewed the manuscript.

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Correspondence to Mora Murri Pierri.

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Ainhoa Robles-Mezcua, Nelsa González Aguado, Antonia Pilar Martin de la Rosa, Concepción Cruzado-Álvarez, Clara Jiménez Rubio, Alejandro I Pérez Cabeza, Juan José Gómez-Doblas, Manuel F. Jiménez-Navarro, Mora Murri Pierri, José M. García-Pinilla declare that they have no conflict of interest.

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Robles-Mezcua, A., Aguado, N.G., de la Rosa, A.P.M. et al. Sex-based Differences in Heart Failure Biomarkers. Curr Heart Fail Rep (2024). https://doi.org/10.1007/s11897-024-00665-x

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