Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Oct;24(10):1751-1766.
doi: 10.1002/ejhf.2664. Epub 2022 Sep 7.

Congestion in heart failure: a circulating biomarker-based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology

Julio Núñez  1   2 , Rafael de la Espriella  1   2 , Patrick Rossignol  3 , Adriaan A Voors  4 , Wilfried Mullens  5 , Marco Metra  6 , Ovidiu Chioncel  7 , James L Januzzi  8 , Christian Mueller  9 , A Mark Richards  10   11 , Rudolf A de Boer  4 , Thomas Thum  12   13 , Henrike Arfsten  14   15 , Arantxa González  2   16 , Magdy Abdelhamid  17 , Stamatis Adamopoulos  18 , Stefan D Anker  19 , Tuvia Ben Gal  20 , Jan Biegus  21 , Alain Cohen-Solal  22 , Michael Böhm  23 , Michele Emdin  24   25 , Ewa A Jankowska  21 , Finn Gustafsson  26 , Loreena Hill  27 , Tiny Jaarsma  28 , Pardeep S Jhund  29 , Yuri Lopatin  30 , Lars H Lund  31 , Davor Milicic  32 , Brenda Moura  33   34 , Massimo F Piepoli  35 , Piotr Ponikowski  21 , Amina Rakisheva  36 , Arsen Ristic  37 , Gianluigi Savarese  31 , Carlo G Tocchetti  38 , Sophie Van Linthout  15   39 , Maurizio Volterrani  40 , Petar Seferovic  41   42 , Giuseppe Rosano  43 , Andrew J S Coats  44 , Antoni Bayes-Genis  2   45   46
Affiliations
Free article
Review

Congestion in heart failure: a circulating biomarker-based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology

Julio Núñez et al. Eur J Heart Fail. 2022 Oct.
Free article

Erratum in

Abstract

Congestion is a cardinal sign of heart failure (HF). In the past, it was seen as a homogeneous epiphenomenon that identified patients with advanced HF. However, current evidence shows that congestion in HF varies in quantity and distribution. This updated view advocates for a congestive-driven classification of HF according to onset (acute vs. chronic), regional distribution (systemic vs. pulmonary), compartment of distribution (intravascular vs. extravascular), and clinical vs. subclinical. Thus, this review will focus on the utility of circulating biomarkers for assessing and managing the different fluid overload phenotypes. This discussion focused on the clinical utility of the natriuretic peptides, carbohydrate antigen 125 (also called mucin 16), bio-adrenomedullin and mid-regional pro-adrenomedullin, ST2 (also known as interleukin-1 receptor-like 1), cluster of differentiation 146, troponin, C-terminal pro-endothelin-1, and parameters of haemoconcentration. The utility of circulation biomarkers on top of clinical evaluation, haemodynamics, and imaging needs to be better determined by dedicated studies. Some multiparametric frameworks in which these tools contribute to management are proposed.

Keywords: Acute heart failure; Biomarkers; Congestion.

PubMed Disclaimer

References

    1. Mullens W, Damman K, Harjola VP, Mebazaa A, Brunner-La Rocca HP, Martens P, et al. The use of diuretics in heart failure with congestion - a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2019;21:137-55.
    1. Packer M. Evolution of the neurohormonal hypothesis to explain the progression of chronic heart failure. Eur Heart J. 1995;16:4-6.
    1. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2016;18:891-975.
    1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al.; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2022;24:4-131.
    1. Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. Eur J Heart Fail. 2021;23:352-80.

Publication types