Cardiovascular biomarkers: increasing impact of laboratory medicine in cardiology practice

Abstract

The practice of cardiology is in continual evolution, in parallel with the progress achieved by medical research in understanding the pathophysiology of cardiovascular disease and in developing new therapeutic procedures. Consequently, manufacturers of cardiac biomarkers are pressed with new demands to improve the performance of the existing and the development of novel ones. Several highly sensitive and/or specific assays for myocardial ischemic damage and myocardial function detection have already become commercially available. Moreover, an increasing number of novel risk factors have been added to the classical risk factors of cardiovascular disease. Finally, the recent surge of genetic analysis procedures will likely soon provide the clinical cardiologist with a number of laboratory tests for defining the molecular diagnosis, assessing new risk factors, and better targeting the pharmaceutical approaches in patients with cardiovascular disease. In this review, we first present the general characteristics of a biomarker followed by the analytical and clinical performance of assay methods.

Thirty years of the heart as an endocrine organ: physiological role and clinical utility of cardiac natriuretic hormones

“…Moreover, some gene polymorphisms of specific natriuretic peptide receptors have associated with some cardiovascular diseases, including systemic arterial hypertension (72,74,96,106), cardiomyopathy (103), and stroke (75). However, the true clinical impact of these studies is still debated, considering that the most frequent cardiovascular diseases are polygenic disorders (99). Finally, at the postreceptor level, an increased activity of the cGMP phosphodiesterase (PDE) V, which metabolizes cGMP, may contribute to increase the resistance to the natriuretic peptide action.…”

Point-of-care test of heart-type fatty acid-binding protein for the diagnosis of early acute myocardial infarction

“…The multi-marker concept was put forward recently in diagnosing AMI, predicting disease risk and evaluating patient outcomes [21,22] . Mion et al used an automated protein biochip microarray system, which allowed a simultaneous determination of six biomarkers, and found that H-FABP+cTnI combination presented the highest sensitivity (83.3%) and specificity (92.2%), and favored it as the most effective "two marker strategy" of the five combinations determined in the study [23] .…”

Biomarkers in Systemic Sclerosis

“…By contrast to the remarkable progress of biomarkers in cancer and cardiovascular disease [17][18][19][20], there are very few validated biomarkers for the assessment of SSc disease activity and for clinical subset disease classification, and their utility has not been extensively tested or validated in clinical trials [21]. Most importantly, there is an important need to develop, test and validate accurate and objective measures of tissue fibrosis and vasculopathy in SSc and markers that may reflect a therapeutic response of the disease process for use in clinical trials.…”