NEUROHUMORAL, CARDIAC, AND INFLAMMATORY INDICATORS IN DETERMINING THE SEVERITY AND PROGRESSION OF HEART FAILURE

Heart failure is a widespread condition among adults, contributing significantly to global morbidity and mortality. Its principal risk factors include coronary artery disease, hypertension, obesity, diabetes mellitus, chronic pulmonary disorders, a family history of cardiovascular disease, and cardiotoxic treatments. A key contributor to poor outcomes in heart failure patients is the ongoing progression of the disease. This review examines the evidence regarding both established and emerging neurohumoral biomarkers for managing and diagnosing heart failure progression. Although numerous biomarkers have been suggested as potentially useful, none yet embody the ideal characteristics needed for effective screening, diagnosis, prognosis, and therapeutic management. Furthermore, the clinical and pathophysiological importance of these biomarkers may vary according to the disease's presentation, stage, and severity. We also discuss the primary classifications of heart failure based on left ventricular ejection fraction—including heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, and the newly defined heart failure with mid-range ejection fraction. Specific biomarker panels may offer varying predictive performance for the progression of heart failure, particularly in forecasting the future course of the disease and in monitoring adverse or reverse left ventricular remodeling. This article aims to provide an overview of both the fundamental and additional mechanisms underlying heart failure progression, contributing to a more comprehensive understanding of its pathogenesis.