Gender-Related Differences in Heart Failure Biomarkers

• Published in: Frontiers in cardiovascular medicine Vol. 7; p. 617705
• Main Authors: Cediel, Germán, Codina, Pau, Spitaleri, Giosafat, Domingo, Mar, Santiago-Vacas, Evelyn, Lupón, Josep, Bayes-Genis, Antoni
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 05.01.2021
• Subjects: biomarker; Cardiovascular Medicine; gender; heart failure; natriuretic peptide; ST2; troponin; ST2; heart failure; gender; troponin; natriuretic peptide; biomarker; Galectine-3
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2020.617705

Important differences in comorbidities and clinical characteristics exist between women and men with heart failure (HF). In particular, differences in the kinetics of biological circulating biomarkers-a critical component of cardiovascular care-are highly relevant. Most circulating HF biomarkers are assessed daily by clinicians without taking sex into account, despite the multiple gender-related differences observed in plasma concentrations. Even in health, compared to men, women tend to exhibit higher levels of natriuretic peptides and galectin-3 and lower levels of cardiac troponins and the cardiac stress marker, soluble ST2. Many biological factors can provide a reliable explanation for these differences, like body composition, fat distribution, or menopausal status. Notwithstanding, these sex-specific differences in biomarker levels do not reflect different pathobiological mechanisms in HF between women and men, and they do not necessarily imply a need to use different diagnostic cut-off levels in clinical practice. To date, the sex-specific prognostic value of HF biomarkers for risk stratification is an unresolved issue that future research must elucidate. This review outlines current evidence regarding gender-related differences in circulating biomarkers widely used in HF, the pathophysiological mechanisms underlying these differences, and their clinical relevance.