Early detection of myocardial dysfunction and heart failure

The impact of cardiac dysfunction and heart failure is continuing to escalate in the developed world. Treatment of this heterogeneous condition has focused on the symptomatic stage, often after irreversible remodeling and functional impairment have occurred. Early identification of cardiac dysfuncti...

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Bibliographic Details
Published inNature reviews cardiology Vol. 7; no. 6; pp. 334 - 344
Main Authors Ouzounian, Maral, de Couto, Geoffrey, Liu, Peter P
Format Journal Article
LanguageEnglish
Published England Nature Publishing Group 01.06.2010
Subjects
Biomarkers - blood
C-Reactive Protein
Care and treatment
Diagnosis
Diagnostic imaging
Disease Progression
Galectin 3
Heart diseases
Heart Diseases - diagnosis
Heart Diseases - pathology
Heart failure
Heart Failure - diagnosis
Heart Failure - pathology
Humans
Medical screening
Methods
Myocardium - pathology
Natriuretic Peptide, Brain
Positron-Emission Tomography
Prognosis
Risk Factors
Time Factors
Tomography, X-Ray Computed
Troponin
Canada
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Summary:The impact of cardiac dysfunction and heart failure is continuing to escalate in the developed world. Treatment of this heterogeneous condition has focused on the symptomatic stage, often after irreversible remodeling and functional impairment have occurred. Early identification of cardiac dysfunction would allow implementation of early intervention strategies to delay the progression or to prevent the onset of heart failure altogether. Although screening methods for asymptomatic cardiac dysfunction have yet to be optimized, a staged approach for patients with predisposing risk factors using serological biomarkers followed by noninvasive imaging techniques may be useful. Existing biomarkers for cardiac dysfunction include B-type natriuretic peptide, troponins, and C-reactive protein. Novel markers such as protein ST2, galectin-3, and various prohormones are emerging and may provide prognostic information that is incremental to conventional clinical evaluation. Monitoring myocardial mechanics and molecular processes through three-dimensional speckle tracking and hybrid imaging modalities, such as PET-CT, may provide insight into disease manifestation before overt structural and physiological abnormalities.
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ISSN:1759-5002
1759-5010
DOI:10.1038/nrcardio.2010.51