Innovations in heart failure management: The role of cutting-edge biomarkers and multi-omics integration

Jose Mesquita Bastos , Beatriz Colaço , Rui Baptista , Cristina Gavina , Rui Vitorino
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Abstract

Heart failure (HF) remains a major cause of morbidity and mortality worldwide and represents a major challenge for diagnosis, prognosis and treatment due to its heterogeneity. Traditional biomarkers such as BNP and NT-proBNP are valuable but insufficient to capture the complexity of HF, especially phenotypes such as HF with preserved ejection fraction (HFpEF). Recent advances in multi-omics technology and novel biomarkers such as cell-free DNA (cfDNA), microRNAs (miRNAs), ST2 and galectin-3 offer transformative potential for HF management. This review explores the integration of these innovative biomarkers into clinical practice and highlights their benefits, such as improved diagnostic accuracy, enhanced risk stratification and non-invasive monitoring capabilities. By leveraging multi-omics approaches, including lipidomics and metabolomics, clinicians can uncover new pathways, refine the classification of HF phenotypes, and develop personalized therapeutic strategies tailored to individual patient profiles. Remarkable advances in proteomics and metabolomics have identified biomarkers associated with key HF mechanisms such as mitochondrial dysfunction, inflammation and fibrosis, paving the way for targeted therapies and early interventions. Despite the promising results, significant challenges remain in translating these findings into routine care, including high costs, technical limitations and the need for large-scale validation studies. This report argues for an integrative, multi-omics-based model to overcome these obstacles and emphasizes the importance of collaboration between researchers, clinicians and policy makers. By linking innovative science with practical applications, multi-omics approaches have the potential to redefine HF management and lead to better patient outcomes and more sustainable healthcare systems.
心衰管理的创新:前沿生物标志物和多组学整合的作用
心力衰竭(HF)仍然是世界范围内发病率和死亡率的主要原因,并且由于其异质性,对诊断、预后和治疗构成了重大挑战。传统的生物标志物,如BNP和NT-proBNP是有价值的,但不足以捕捉HF的复杂性,特别是表现型,如保留射血分数(HFpEF)的HF。多组学技术的最新进展和新的生物标志物,如无细胞DNA (cfDNA)、microRNAs (miRNAs)、ST2和半乳糖凝集素-3,为HF治疗提供了变革潜力。这篇综述探讨了将这些创新的生物标志物整合到临床实践中,并强调了它们的好处,如提高诊断准确性,增强风险分层和非侵入性监测能力。通过利用多组学方法,包括脂质组学和代谢组学,临床医生可以发现新的途径,完善HF表型的分类,并根据个体患者的情况制定个性化的治疗策略。蛋白质组学和代谢组学的显著进展已经确定了与HF关键机制(如线粒体功能障碍、炎症和纤维化)相关的生物标志物,为靶向治疗和早期干预铺平了道路。尽管取得了令人鼓舞的结果,但在将这些发现转化为常规护理方面仍然存在重大挑战,包括高成本、技术限制和大规模验证研究的需要。本报告主张采用一种综合的、基于多组学的模式来克服这些障碍,并强调研究人员、临床医生和决策者之间合作的重要性。通过将创新科学与实际应用相结合,多组学方法有可能重新定义心衰管理,并导致更好的患者结果和更可持续的医疗保健系统。
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来源期刊
Journal of molecular and cellular cardiology plus
Journal of molecular and cellular cardiology plus Cardiology and Cardiovascular Medicine
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