Cardiorenal biomarkers in acute heart failure

Abstract

Managing patients with heart failure (HF) is a challenging task within itself, but the presence of associated worsening renal function can greatly increase mortality and morbidity. Early diagnosis and treatment is the key to prevent re-hospitalizations and reduce healthcare costs. Biomarkers have long been established as highly sensitive and specific tools in diagnosing and prognosticating patients with HF. Reflecting distinct pathophysiological events and ongoing cellular insult, biomarkers have been proven superior to conventional laboratory tests. Availability of better assays and rapid analysis has allowed the use of biomarkers as point-of-care tests in the emergency department and at the patient's bed-side. Acute HF patients often go on to develop worsening renal function, termed as acute cardiorenal syndrome. The growing breadth of studies has shown the implications of combining multiple biomarkers to better chart outcomes and produce desirable results in such patients.

Comparison Between Age and Left Ventricular Ejection Fraction in Prediction of Renal Dysfunction in Cardiorenal Syndrome Type 1 and 2

“…According to heart failure (HF) registry databases, renal dysfunction (RD) is the most frequent comorbidity in HF patients associated with high in-patient mortality rates (4). Patients with acute HF can be classified as de novo HF and acu-te decompensated HF depending on the onset and duration of their symptoms (5).…”

“…Acute HF is characterized by diminished left ventricular systolic function and poor cardiac output, activating compensatory mechanisms such as the reninangiotensin-aldosterone system, sympathetic system, and other local mediators, which interact to maintain the fluid volume (6)(7)(8). Furthermore, decreased renal perfusion, in addition to nephrotoxic agents and over-diuresis, eventually leads to acute kidney injury (AKI) in such patients (5). The end result of these hemodynamic disturbances in the kidney is a loss of auto regulation and the onset of worsened salt and water retention, reduction in renal filtration, and oliguria (2).…”