Biomarkers in acute decompensated heart failure

Acute decompensated heart failure (ADHF) is a prominent condition whose frequency is increasing, especially in the context of an aging population. The ability to discern the cause of undifferentiated dyspnea in acute presentations is an increasing struggle. In this review, we seek to explore the various biomarkers that have been studied for the diagnosis of ADHF and their respective clinical utilities as the most recent data would suggest. Natriuretic peptides, galectin-3, soluble ST2, adrenomedullin, cardiac troponin-T, neutrophil gelatinase-associated lipocalin, and copeptin are reviewed. Of these biomarkers, natriuretic peptides are the most thoroughly evaluated and show the most promise for diagnosis or exclusion of acute heart failure, though other biomarkers can add significant utility in the form of prognostication.