Novel biomarkers of heart failure are the subject of numerous studies. Biomarkers of heart failure can be determined in the blood and in the urine. Seven groups of biomarkers of heart failure based on pathophysiological mechanisms are presented in this review, namely biomarkers of myocardial stretch, myocyte injury, myocardial remodeling, biomarkers of inflammation, renal dysfunction, neurohumoral activation, and oxidative stress. Studies of biomarkers in the pediatric population are scarce, therefore, further investigation is needed for reliable prognostic and therapeutic implications. The future of biomarker use is in multimarker panels that include a combination of biomarkers with different pathophysiological mechanisms in order to improve their diagnostic and prognostic predictive value.
The main goals of a good echocardiographic examination are an accurate assessment of myocardial function and precise presentation of cardiac morphology. Therefore, some new echocardiographic methods, such as functional echocardiography, cardiac deformation imaging, and 3D echocardiography, are becoming increasingly useful. The main advantages of each method, the possibilities for clinical use, and the most important limitations are presented in this paper. Functional echocardiography enables real-time evaluation of cardiac performance, identifying the nature of cardiovascular compromise, guiding therapeutic decisions, and monitoring response to treatment. A better understanding of the cardiac function and hemodynamic changes in critically ill patients is a crucial clinical benefit of the method. Myocardial deformation imaging could be beneficial for the detection of early ventricular dysfunction, especially where classical methods are unreliable. The new methods do not rely on geometric assumptions and can quantify regional as well as global ventricular function. 3D echocardiography allows understanding of complex spatial cardiac relationships; furthermore, it can be valuable in understanding functional anatomy and help planning interventions.
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