Advanced Heart Failure and Onset of New Prognostic Markers: Where are We?

Advanced heart failure (HF) is a complex syndrome characterized by the presence of severe and persistent symptoms of HF, important cardiac dysfunction, episodes of pulmonary or systemic congestion requiring high-dose of intravenous diuretics, episodes of low output requiring inotropes or vasoactive drugs, malignant arrhythmias, hospitalization in the past 12 months or severe impairment of exercise capacity. The utility of multiple markers that have good accuracy in the detection of worse prognosis are increasingly being explored in the literature. Brain natriuretic peptide (BNP) and NT-proBNP are considered biomarkers prognostic indicators in HF and can help to identify patients with more severity of disease.

Recently, the onset of new echocardiographic markers appears to play an important role in detecting patients with more severe progression of this syndrome. Various parameters derived from the innovative speckle tracking echocardiography (STE) technique are of great value in the diagnostic and prognostic of several pathologies.^–

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