Abstract
Myocardial remodelling, entailing cellular and molecular changes in the different components of the cardiac tissue in response to damage, underlies the morphological and structural changes leading to cardiac remodelling, which in turn contributes to cardiac dysfunction and disease progression. Since cardiac tissue is not available for histomolecular diagnosis, surrogate markers are needed for evaluating myocardial remodelling as part of the clinical management of patients with cardiac disease. In this setting, circulating biomarkers, a component of the liquid biopsy, provide a promising approach for the fast, affordable and scalable screening of large numbers of patients, allowing the detection of different pathological features related to myocardial remodelling, aiding in risk stratification and therapy monitoring. However, despite the advances in the field and the identification of numerous potential candidates, their implementation in clinical practice beyond natriuretic peptides and troponins is mostly lacking. In this review, we will discuss some biomarkers related to alterations in the main cardiac tissue compartments (cardiomyocytes, extracellular matrix, endothelium and immune cells) which have shown potential for the assessment of cardiovascular risk, cardiac remodelling and therapy effects. The hurdles and challenges for their translation into clinical practice will also be addressed.
Funder
Dirección General de Industria, Energia y Proyectos Estrategicos S3, Gobierno de Navarra
Horizon 2020 Framework Programme
Instituto de Salud Carlos III
Agencia Estatal de Investigación
Reference60 articles.
1. Cardiac remodelling-part 1: from cells and tissues to circulating biomarkers. A review from the study group on biomarkers of the heart failure association of the European society of cardiology;González;Eur J Heart Fail,2022
2. Pathological Ventricular Remodeling
3. Myocardial extracellular volume quantification by cardiovascular magnetic resonance and computed tomography;Scully;Curr Cardiol Rep,2018
4. Phenotyping heart failure by nuclear imaging of myocardial perfusion, metabolism, and molecular targets;Saraste;Eur Heart J Cardiovasc Imaging,2023
5. Myocardial injury, troponin release, and cardiomyocyte death in brief ischemia, failure, and ventricular remodeling;Canty;Am J Physiol Heart Circ Physiol,2022