Current Review of Heart Failure-Related Risk and Prognostic Factors

Heart failure (HF) is a complex clinical syndrome characterized by the heart’s inability to maintain sufficient circulation, leading to inadequate organ perfusion and fluid buildup. A thorough understanding of the molecular, biochemical, and hemodynamic interactions that underlie this condition is e...

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Main Authors: Michał Maksymilian Wilk, Jakub Wilk, Szymon Urban, Piotr Gajewski
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Biomedicines
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Online Access:https://www.mdpi.com/2227-9059/12/11/2560
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author Michał Maksymilian Wilk
Jakub Wilk
Szymon Urban
Piotr Gajewski
author_facet Michał Maksymilian Wilk
Jakub Wilk
Szymon Urban
Piotr Gajewski
author_sort Michał Maksymilian Wilk
collection DOAJ
description Heart failure (HF) is a complex clinical syndrome characterized by the heart’s inability to maintain sufficient circulation, leading to inadequate organ perfusion and fluid buildup. A thorough understanding of the molecular, biochemical, and hemodynamic interactions that underlie this condition is essential for improving its management and enhancing patient outcomes. Recent advancements in cardiovascular research have emphasized the critical role of microRNAs (miRNAs) as post-transcriptional regulators of gene expression, playing an important part in the development and progression of HF. This review aims to explore the contributions of miRNAs, systemic congestion markers, and traditional biomarkers to the pathophysiology of heart failure, with the objective of clarifying their prognostic value and potential clinical applications. Among the miRNAs studied, miR-30d, miR-126-3p, and miR-483-3p have been identified as key players in processes such as left ventricular remodeling, regulation of pulmonary artery pressure, and adaptation of the right ventricle. These findings underscore the importance of miRNAs in modulating the structural and functional changes seen in HF. Beyond the heart, HF affects multiple organ systems, including the kidneys and liver, with markers of dysfunction in these organs—such as worsening renal function and liver stiffness—being closely linked to increased morbidity and mortality. This highlights the interdependence of the heart and other organs, where systemic congestion, indicated by elevated venous pressures, exacerbates organ dysfunction. In this context, traditional biomarkers like natriuretic peptides and cardiac troponins remain vital tools in the diagnosis and management of HF. Natriuretic peptides reflect ventricular strain, while troponins are indicators of myocardial injury, both of which are critical for risk stratification and monitoring disease progression. Emerging diagnostic techniques, such as lung ultrasonography and advanced echocardiographic methods, offer new ways to assess hemodynamic status, further aiding therapeutic decision-making. These techniques, alongside established biomarkers, provide a more comprehensive approach to understanding the complexities of heart failure and managing its impact on patients. In conclusion, miRNAs, systemic congestion markers, and traditional biomarkers are indispensable for understanding HF pathophysiology and determining patient prognosis. The integration of novel diagnostic tools with existing biomarkers holds the promise of improved strategies for the management of heart failure. However, further research is needed to validate their prognostic value and refine their role in optimizing treatment outcomes.
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spelling doaj-art-224a296d217143e9943e05557707d0002024-11-26T17:53:13ZengMDPI AGBiomedicines2227-90592024-11-011211256010.3390/biomedicines12112560Current Review of Heart Failure-Related Risk and Prognostic FactorsMichał Maksymilian Wilk0Jakub Wilk1Szymon Urban2Piotr Gajewski3Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, 50-376 Wroclaw, PolandStudent Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University, 50-376 Wroclaw, PolandInstitute of Heart Diseases, Wroclaw Medical University, 50-376 Wroclaw, PolandInstitute of Heart Diseases, Wroclaw Medical University, 50-376 Wroclaw, PolandHeart failure (HF) is a complex clinical syndrome characterized by the heart’s inability to maintain sufficient circulation, leading to inadequate organ perfusion and fluid buildup. A thorough understanding of the molecular, biochemical, and hemodynamic interactions that underlie this condition is essential for improving its management and enhancing patient outcomes. Recent advancements in cardiovascular research have emphasized the critical role of microRNAs (miRNAs) as post-transcriptional regulators of gene expression, playing an important part in the development and progression of HF. This review aims to explore the contributions of miRNAs, systemic congestion markers, and traditional biomarkers to the pathophysiology of heart failure, with the objective of clarifying their prognostic value and potential clinical applications. Among the miRNAs studied, miR-30d, miR-126-3p, and miR-483-3p have been identified as key players in processes such as left ventricular remodeling, regulation of pulmonary artery pressure, and adaptation of the right ventricle. These findings underscore the importance of miRNAs in modulating the structural and functional changes seen in HF. Beyond the heart, HF affects multiple organ systems, including the kidneys and liver, with markers of dysfunction in these organs—such as worsening renal function and liver stiffness—being closely linked to increased morbidity and mortality. This highlights the interdependence of the heart and other organs, where systemic congestion, indicated by elevated venous pressures, exacerbates organ dysfunction. In this context, traditional biomarkers like natriuretic peptides and cardiac troponins remain vital tools in the diagnosis and management of HF. Natriuretic peptides reflect ventricular strain, while troponins are indicators of myocardial injury, both of which are critical for risk stratification and monitoring disease progression. Emerging diagnostic techniques, such as lung ultrasonography and advanced echocardiographic methods, offer new ways to assess hemodynamic status, further aiding therapeutic decision-making. These techniques, alongside established biomarkers, provide a more comprehensive approach to understanding the complexities of heart failure and managing its impact on patients. In conclusion, miRNAs, systemic congestion markers, and traditional biomarkers are indispensable for understanding HF pathophysiology and determining patient prognosis. The integration of novel diagnostic tools with existing biomarkers holds the promise of improved strategies for the management of heart failure. However, further research is needed to validate their prognostic value and refine their role in optimizing treatment outcomes.https://www.mdpi.com/2227-9059/12/11/2560heart failurediureticsbiomarkers
spellingShingle Michał Maksymilian Wilk
Jakub Wilk
Szymon Urban
Piotr Gajewski
Current Review of Heart Failure-Related Risk and Prognostic Factors
Biomedicines
heart failure
diuretics
biomarkers
title Current Review of Heart Failure-Related Risk and Prognostic Factors
title_full Current Review of Heart Failure-Related Risk and Prognostic Factors
title_fullStr Current Review of Heart Failure-Related Risk and Prognostic Factors
title_full_unstemmed Current Review of Heart Failure-Related Risk and Prognostic Factors
title_short Current Review of Heart Failure-Related Risk and Prognostic Factors
title_sort current review of heart failure related risk and prognostic factors
topic heart failure
diuretics
biomarkers
url https://www.mdpi.com/2227-9059/12/11/2560
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AT piotrgajewski currentreviewofheartfailurerelatedriskandprognosticfactors