Introduction: biomarkers in heart failure

Excerpt

Practitioners have long known that the clinical manifestations of cardiovascular disease, exemplified by signs and symptoms, may be nonspecific and confusing during the diagnostic process. Worse, these classical clinical indicators do not fully reflect the extent of the underlying pathophysiological process and may give an incomplete picture of prognosis. In addition, the treatment of cardiovascular disease has become increasingly complex, with polypharmacy, the rule and novel devices often of benefit, but standard clinical assessment often does not indicate what combination of therapy should be used or adequately reflect the response to treatment. Finally, signs and symptoms typically emerge late in the natural history of these disorders, delaying their identification until after preventative measures and early treatments could have reduced disease burden. These considerations point to the limitations of standard clinical assessment for the diagnosis, prognostic stratification, and monitoring of therapeutic response in cardiovascular disease and indicate more sophisticated characterization of the clinical phenotype is needed. …