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Review
. 2023 Jan 13;13(1):173.
doi: 10.3390/biom13010173.

Laboratory and Metabolomic Fingerprint in Heart Failure with Preserved Ejection Fraction: From Clinical Classification to Biomarker Signature

Alberto Palazzuoli  1 , Francesco Tramonte  1 , Matteo Beltrami  2
Affiliations
Review

Laboratory and Metabolomic Fingerprint in Heart Failure with Preserved Ejection Fraction: From Clinical Classification to Biomarker Signature

Alberto Palazzuoli et al. Biomolecules. .

Abstract

Heart failure with preserved ejection fraction (HFpEF) remains a poorly characterized syndrome with many unknown aspects related to different patient profiles, various associated risk factors and a wide range of aetiologies. It comprises several pathophysiological pathways, such as endothelial dysfunction, myocardial fibrosis, extracellular matrix deposition and intense inflammatory system activation. Until now, HFpEF has only been described with regard to clinical features and its most commonly associated risk factors, disregarding all biological mechanisms responsible for cardiovascular deteriorations. Recently, innovations in laboratory and metabolomic findings have shown that HFpEF appears to be strictly related to specific cells and molecular mechanisms' dysregulation. Indeed, some biomarkers are efficient in early identification of these processes, adding new insights into diagnosis and risk stratification. Moreover, recent advances in intermediate metabolites provide relevant information on intrinsic cellular and energetic substrate alterations. Therefore, a systematic combination of clinical imaging and laboratory findings may lead to a 'precision medicine' approach providing prognostic and therapeutic advantages. The current review reports traditional and emerging biomarkers in HFpEF and it purposes a new diagnostic approach based on integrative information achieved from risk factor burden, hemodynamic dysfunction and biomarkers' signature partnership.

Keywords: HFpEF; biomarkers; metabolomic; microRNA.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distinct HFpEF clinical phenotypes based on clinical-presentation-associated metabolic disorders and comorbidities.
Figure 2
Figure 2
Potential pathophysiological mechanisms occurring in HFpEF: each disorder can be recognized by specific biomarker increase and overexpression. The partnership between clinical and laboratory information may better target the HFpEF profile.
See this image and copyright information in PMC

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