Biomarkers articles within Nature Reviews Cardiology

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  • Review Article |

    In this Review, Gaillard and Jaddoe describe how maternal cardiovascular disorders, occurring before and during pregnancy, can influence cardiovascular health in the offspring from embryonic life until adulthood. Furthermore, the authors highlight critical periods for cardiovascular adaptations, including preconception, early pregnancy and infancy, and how the events occurring during these periods can have an effect on future cardiovascular health.

    • Romy Gaillard
    •  & Vincent W. V. Jaddoe

  • Review Article |

    In this Review, Münzel and colleagues describe the exposome concept with a focus on environmental physical and chemical exposures and their effects on the burden of cardiovascular disease. Additionally, they discuss selected exposome studies and the relevance of the exposome concept for future health research and preventive medicine.

    • Thomas Münzel
    • , Mette Sørensen
    •  & Andreas Daiber

  • Research Highlight |

    A wrist-worn, transdermal sensor can be used to measure plasma levels of cardiac troponin I, potentially facilitating the diagnosis of myocardial infarction.

    • Gregory B. Lim

  • Clinical Outlook |

    Hypertrophic cardiomyopathy (HCM) is defined by ventricular hypertrophy. However, the broader phenotype includes abnormal cardiomyocyte orientation (disarray), myocardial ischaemia and electrical abnormalities, which seem to manifest before overt hypertrophy. With advances in cascade genetic testing and novel therapeutic agents, the detection of subclinical HCM is a rapidly emerging priority. In this context, we outline the role of novel biomarkers, particularly quantitative perfusion and diffusion tensor MRI.

    • George Joy
    • , James C. Moon
    •  & Luis R. Lopes

  • Comment |

    Low plasma levels of HDL cholesterol are a risk factor for infection and hospitalization for infectious disease. Recent work suggests that inadequate levels of HDL particles of specific sizes — small and medium — account for this risk. In this Comment, we discuss the mechanistic implications of these observations and the methodologies used to quantify HDL size.

    • Jay W. Heinecke
    •  & W. Sean Davidson

  • News & Views |

    Health-care delivery is evolving, with an increased availability of consumer and medical technology-enabled diagnostic devices powered by artificial intelligence. Physicians need to evolve by deprioritizing old skills in favour of new skills in statistics and medical decision-making psychology. Technology moves fast; physicians will need to pivot and adapt quickly.

    • Rashmee U. Shah

  • News & Views |

    Cardiovascular disease is both a risk factor and potential outcome of the direct, indirect and long-term effects of COVID-19. A recent analysis in >150,000 survivors of COVID-19 demonstrates an increased 1-year risk of numerous cardiovascular diseases. Preventing and managing this new disease burden presents challenges to health systems and requires a learning health system approach.

    • Mohamed O. Mohamed
    •  & Amitava Banerjee

  • Consensus Statement |

    In this Consensus Statement, the authors delineate the thrombotic signature of COVID-19 and present the latest biomarkers and platforms to assess thrombotic risk in these patients. Consensus recommendations are made about the clinical use of these biomarkers to inform prognosis, assess disease acuity, and predict thrombosis and in-hospital mortality.

    • Diana A. Gorog
    • , Robert F. Storey
    •  & Richard C. Becker

  • Comment |

    Precision medicine envisages a changed paradigm for health care through better understanding of individual disease susceptibility and prognosis, enabling more personalized treatment. Enabling technologies such as the health digital twin are rapidly evolving, presenting important challenges and opportunities to be tackled within local contexts.

    • Genevieve Coorey
    • , Gemma A. Figtree
    •  & Julie Redfern

  • Review Article |

    Cardiovascular disease (CVD) and erectile dysfunction (ED) have shared risk factors and mechanisms. Moreover, ED is an independent predictor of CVD events and is an adverse effect of some cardiovascular drugs. This Review discusses how sexual function should be considered when treating patients with CVD to improve quality of life and cardiovascular outcomes.

    • Dimitrios Terentes-Printzios
    • , Nikolaos Ioakeimidis
    •  & Charalambos Vlachopoulos

  • Review Article |

    The metabolism of lipids accumulated in blood vessel walls and the heart produces sphingolipids, such as ceramides, which are associated with the development of diabetes mellitus, atherosclerosis, hypertension and heart failure. In this Review, the authors discuss ceramides as drivers of cardiovascular disease and therapeutic strategies to lower plasma and cardiac levels of ceramides.

    • Ran Hee Choi
    • , Sean M. Tatum
    •  & William L. Holland

  • Review Article |

    In this Review, Holmes and colleagues compare and contrast the use of Mendelian randomization to evaluate potential drug targets versus quantitative traits and explain how genetic epidemiological studies can be used to assess the aetiological roles of biomarkers in disease and to prioritize drug targets, including designing their evaluation in clinical trials.

    • Michael V. Holmes
    • , Tom G. Richardson
    •  & George Davey Smith

  • Review Article |

    In this Review, Díez and colleagues summarize the mechanisms of diffuse myocardial fibrosis in heart failure, discuss imaging techniques and circulating biomarkers to characterize the variability of this lesion in patients, and highlight the available and potential future therapeutic strategies for personalizing the prevention and reversal of diffuse myocardial fibrosis.

    • Begoña López
    • , Susana Ravassa
    •  & Javier Díez

  • Research Highlight |

    Higher levels of angiotensin-converting enzyme 2 in plasma are associated with a greater risk of major cardiovascular disease events, according to a global, population-based study.

    • Irene Fernández-Ruiz

  • Review Article |

    The heart is an endocrine organ, producing atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in a regulated manner. In this Review, the authors discuss the physiological regulation and actions of the cardiac natriuretic peptides and their clinical use as powerful diagnostic and prognostic biomarkers of heart disease.

    • Jens P. Goetze
    • , Benoit G. Bruneau
    •  & Adolfo J. de Bold

  • News & Views |

    The myocardial viability substudy from the STICH trial has reaffirmed the 10-year survival benefit of CABG surgery in patients with left ventricular dysfunction, but whether myocardial viability must be present for the long-term benefits of revascularization to be realized remains inconclusive.

    • Björn Redfors
    •  & Gregg W. Stone

  • Research Highlight |

    Two studies reveal new details of the mechanisms underlying the benefits of the angiotensin receptor–neprilysin inhibitor sacubitril–valsartan in patients with heart failure and reduced ejection fraction, suggesting that sacubitril–valsartan induces reverse cardiac remodelling but has no effect in reducing central aortic stiffness.

    • Irene Fernández-Ruiz

  • Research Highlight |

    High-sensitivity troponin I levels are positively and strongly linked with incident coronary heart disease, heart failure hospitalization and all-cause mortality in individuals without known cardiovascular disease.

    • Karina Huynh

  • Comment |

    Retinal microvascular changes are strongly linked to prevalent and incident cardiovascular disease. These changes can now be mapped with unparalleled accuracy using retinal optical coherence tomography. Novel retinal imaging, combined with the power of deep learning, might soon equip clinicians with unique and precise risk-assessment tools that enable truly individualized patient management.

    • Tariq E. Farrah
    • , David J. Webb
    •  & Neeraj Dhaun

  • Review Article |

    Circular RNAs (circRNAs) are emerging as a new class of non-coding RNA molecules. In this Review, the authors discuss the current understanding of circRNA biogenesis and function, with a particular emphasis on the cardiovascular system.

    • Simona Aufiero
    • , Yolan J. Reckman
    •  & Esther E. Creemers

  • Year in Review |

    A number of papers published in 2018 have provided important information expected to influence clinical practice, particularly for the management of functional mitral regurgitation in patients with heart failure caused by ischaemic or non-ischaemic cardiomyopathy and for the treatment of severe aortic stenosis in patients at low surgical risk.

    • Ottavio Alfieri

  • News & Views |

    High-sensitivity cardiac troponin (hs-cTn) assays facilitate the ruling-out of myocardial infarction (MI) but identify a high number of patients with elevated troponin levels but without MI. Consequently, the term myocardial injury was included in the latest universal definition of MI. In the High-STEACS trial, use of a hs-cTnI assay was safe but had no prognostic benefit.

    • Till Keller
    •  & Christian W. Hamm

  • Review Article |

    This Review summarizes the growing body of evidence implicating cathepsin activities in the pathogenesis of several cardiovascular diseases, outlining the potential of cathepsins as biomarkers of disease progression and discussing clinical trials of cathepsin inhibitors in other diseases that highlight opportunities for developing novel therapies targeting cathepsins in cardiovascular diseases.

    • Cong-Lin Liu
    • , Junli Guo
    •  & Guo-Ping Shi

  • Review Article |

    HDL-cholesterol levels in plasma predict the risk of cardiovascular disease, but a direct causal role for HDL in cardiovascular disease remains controversial. In this Review, Rosenson et al. discuss the opportunities afforded by an integrated approach that combines human genetic studies with systems biology to understand the complex metabolism of HDL and its potential atheroprotective properties.

    • Robert S. Rosenson
    • , H. Bryan Brewer Jr
    •  & Robert A. Hegele

  • Review Article |

    Troponin is a widely used biomarker in patients with cardiac disease. In this Review, Westermann et al. describe the development of high-sensitivity assays for troponin, and their practical use in clinical diagnosis of acute myocardial infarction. Elevated concentrations of troponin in myocardial injury and chronic cardiac disease are also discussed.

    • Dirk Westermann
    • , Johannes Tobias Neumann
    •  & Stefan Blankenberg

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