Circulating Biomarkers of Myocardial Fibrosis: The Need for a Reappraisal.

J Am Coll Cardiol

Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, Pamplona, Spain. Electronic address:

Published: June 2015

AI Article Synopsis

  • Myocardial fibrosis negatively affects heart function and can lead to serious heart conditions, making its assessment important for patient care.
  • While tissue biopsy is the most reliable method for diagnosing myocardial fibrosis, several blood-based biomarkers have been suggested for a noninvasive approach.
  • Current evidence shows that most of these biomarkers don’t reliably indicate the presence of myocardial fibrosis, highlighting the need for stricter validation before they can be used in clinical settings.

Article Abstract

Myocardial fibrosis impairs cardiac function, in addition to facilitating arrhythmias and ischemia, and thus influences the evolution and outcome of cardiac diseases. Its assessment is therefore clinically relevant. Although tissue biopsy is the gold standard for the diagnosis of myocardial fibrosis, a number of circulating biomarkers have been proposed for the noninvasive assessment of this lesion. A review of the published clinical data available on these biomarkers shows that most of them lack proof that they actually reflect the myocardial accumulation of fibrous tissue. In this "call to action" article, we propose that this absence of proof may lead to misinterpretations when considering the incremental value provided by the biomarkers with respect to traditional diagnostic tools in the clinical handling of patients. We thus argue that strategies are needed to more strictly validate whether a given circulating biomarker actually reflects histologically proven myocardial fibrosis before it is applied clinically.

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Source
http://dx.doi.org/10.1016/j.jacc.2015.04.026DOI Listing

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