AVANÇOS NO USO DE BIOMARCADORES PARA DIAGNÓSTICO DE INSUFICIÊNCIA CARDÍACA: UMA REVISÃO DE LITERATURA

Abstract

Heart failure (HF) is a complex clinical condition characterized by the heart's inability to maintain an adequate blood flow to meet the metabolic needs of tissues. Although advances in pharmacological and non-pharmacological management have improved outcomes for many patients, early and accurate diagnosis remains a critical need. Traditional biomarkers, such as B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP), have played a central role in clinical practice, aiding in risk stratification and diagnostic confirmation. However, the search for biomarkers reflecting multiple aspects of HF pathophysiology has led to the emergence of new molecular tools with expanded clinical potential. This study aims to explore recent advances in the use of biomarkers for the diagnosis of heart failure, discussing their application and relevance in clinical practice. Through a narrative literature review, databases such as PubMed, SciELO, and Cochrane Library were consulted, using keyword combinations related to HF and biomarkers. Studies published in the last ten years focusing on traditional and emerging biomarkers were included, while duplicate or irrelevant articles were excluded. Extracted information was analyzed qualitatively, grouping biomarkers according to their clinical and molecular functions. The results highlighted the role of emerging biomarkers such as galectin-3, cystatin C, soluble ST2 (sST2), and NGAL, which provide complementary information to that offered by traditional biomarkers. Galectin-3, for instance, is an indicator of cardiac fibrosis and remodeling, while sST2 is associated with mechanical stress and inflammation. Additionally, markers like cystatin C and NGAL stand out for their ability to detect early renal dysfunctions often associated with HF. Despite their promising potential, challenges related to method standardization and validation in diverse populations remain to be addressed. The integration of emerging biomarkers into the diagnostic arsenal allows for a broader understanding of HF pathophysiology, promoting earlier and more personalized interventions. This study reinforces the need to continue exploring new molecular tools, consolidating biomarkers as fundamental pillars for the clinical management of heart failure.