Biomarkers in Heart Failure: A Review and a Wish.

Natriuretic peptides (NPs) have significantly improved the assessment and management of patients with heart failure (HF), but they present several limitations. It is now clear that no single biomarker can adequately guide the diagnosis, prognosis, and outcomes of HF. Therefore, the use of multiple biomarkers, correlated with HF pathophysiology, may improve HF management. An exponential number of emerging biomarkers have been reported in the literature, and when combined, they demonstrate greater clinical relevance than when used alone. They are also increasingly used as targets in the development of innovative treatments, such as targeted and personalized therapies. Their identification and clinical relevance could also be facilitated by the application of artificial intelligence models and the use of multi-omics approaches. This article presents a detailed overview of emerging biomarkers, potential targets, and innovative therapies, illustrating their advantages and limitations, as well as possible solutions to overcome them, and highlighting their strong, promising potential. This could enable the prediction of the spread of this disease in the general population, enabling early diagnosis and limiting complications and mortality. The path to achieving this goal is arduous, but it is achievable. This will require further efforts by researchers and clinicians with diverse multidisciplinary expertise.