Evaluation of the diagnostic accuracy of current biomarkers in heart failure with preserved ejection fraction: A systematic review and meta-analysis.

Chen, H; Chhor, M; Rayner, BS; McGrath, K; McClements, L

Evaluation of the diagnostic accuracy of current biomarkers in heart failure with preserved ejection fraction: A systematic review and meta-analysis.

Chen, H Chhor, M Rayner, BS McGrath, K

McClements, L

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Arch Cardiovasc Dis, 2021, 114, (12), pp. 793-804
Issue Date:: 2021-12

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Field	Value	Language
dc.contributor.author	Chen, H
dc.contributor.author	Chhor, M
dc.contributor.author	Rayner, BS
dc.contributor.author	McGrath, K https://orcid.org/0000-0002-6244-3929
dc.contributor.author	McClements, L https://orcid.org/0000-0002-4911-1014
dc.date.accessioned	2022-01-11T23:34:07Z
dc.date.available	2021-10-21
dc.date.available	2022-01-11T23:34:07Z
dc.date.issued	2021-12
dc.identifier.citation	Arch Cardiovasc Dis, 2021, 114, (12), pp. 793-804
dc.identifier.issn	1875-2136
dc.identifier.issn	1875-2128
dc.identifier.uri	http://hdl.handle.net/10453/152942
dc.description.abstract	BACKGROUND: A number of circulating biomarkers are currently utilized for the diagnosis of chronic heart failure with preserved ejection fraction (HFpEF). However, due to HFpEF heterogeneity, the accuracy of these biomarkers remains unclear. AIMS: This study aimed to systematically determine the diagnostic accuracy of currently available biomarkers for chronic HFpEF. METHODS: PubMed, Web of Science, MEDLINE and SCOPUS databases were searched systematically to identify studies assessing the diagnostic accuracy of biomarkers of chronic HFpEF with left ventricular ejection fraction (LVEF) ≥50%. All included studies were independently assessed for quality and relevant information was extracted. Random-effects models were used to estimate the pooled diagnostic accuracy of HFpEF biomarkers. RESULTS: The search identified 6145 studies, of which 19 were included. Four biomarkers were available for meta-analysis. The pooled sensitivity of B-type natriuretic peptide (BNP) (0.787, 95% confidence interval [CI] 0.719-0.842) was higher than that of N-terminal pro-BNP (NT-proBNP) (0.696, 95% CI 0.599-0.779) in chronic HFpEF diagnosis. However, NT-proBNP showed improved specificity (0.882, 95% CI 0.778-0.941) compared to BNP (\0.796, 95% CI 0.672-0.882). Galectin-3 (Gal-3) exhibited a reliable diagnostic adequacy for HFpEF (sensitivity 0.760, 95% CI 0.631-0.855; specificity 0.803, 95% CI 0.667-0.893). However, suppression of tumorigenesis-2 (ST2) displayed limited diagnostic performance for chronic HFpEF diagnosis (sensitivity 0.636, 95% CI 0.465-0.779; specificity 0.595, 95% CI 0.427-0.743). CONCLUSION: NT-proBNP and BNP appear to be the most reliable biomarkers in chronic HFpEF with NT-proBNP showing higher specificity and BNP showing higher sensitivity. Although Gal-3 appears more reliable than ST2 in HFpEF diagnosis, the conclusions are limited as only three studies were included in this meta-analysis.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation.ispartof	Arch Cardiovasc Dis
dc.relation.isbasedon	10.1016/j.acvd.2021.10.007
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	1103 Clinical Sciences
dc.subject.classification	Cardiovascular System & Hematology
dc.subject.mesh	Biomarkers
dc.subject.mesh	Heart Failure
dc.subject.mesh	Humans
dc.subject.mesh	Natriuretic Peptide, Brain
dc.subject.mesh	Peptide Fragments
dc.subject.mesh	Prognosis
dc.subject.mesh	Stroke Volume
dc.subject.mesh	Ventricular Function, Left
dc.title	Evaluation of the diagnostic accuracy of current biomarkers in heart failure with preserved ejection fraction: A systematic review and meta-analysis.
dc.type	Journal Article
utslib.citation.volume	114
utslib.location.activity	Netherlands
utslib.for	1103 Clinical Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
pubs.organisational-group	/University of Technology Sydney/Strength - IBMD - Initiative for Biomedical Devices
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
utslib.copyright.status	open_access	*
utslib.copyright.embargo	2022-12-01T00:00:00+1000Z
dc.date.updated	2022-01-11T23:33:46Z
pubs.issue	12
pubs.publication-status	Published
pubs.volume	114
utslib.citation.issue	12

Abstract:

BACKGROUND: A number of circulating biomarkers are currently utilized for the diagnosis of chronic heart failure with preserved ejection fraction (HFpEF). However, due to HFpEF heterogeneity, the accuracy of these biomarkers remains unclear. AIMS: This study aimed to systematically determine the diagnostic accuracy of currently available biomarkers for chronic HFpEF. METHODS: PubMed, Web of Science, MEDLINE and SCOPUS databases were searched systematically to identify studies assessing the diagnostic accuracy of biomarkers of chronic HFpEF with left ventricular ejection fraction (LVEF) ≥50%. All included studies were independently assessed for quality and relevant information was extracted. Random-effects models were used to estimate the pooled diagnostic accuracy of HFpEF biomarkers. RESULTS: The search identified 6145 studies, of which 19 were included. Four biomarkers were available for meta-analysis. The pooled sensitivity of B-type natriuretic peptide (BNP) (0.787, 95% confidence interval [CI] 0.719-0.842) was higher than that of N-terminal pro-BNP (NT-proBNP) (0.696, 95% CI 0.599-0.779) in chronic HFpEF diagnosis. However, NT-proBNP showed improved specificity (0.882, 95% CI 0.778-0.941) compared to BNP (\0.796, 95% CI 0.672-0.882). Galectin-3 (Gal-3) exhibited a reliable diagnostic adequacy for HFpEF (sensitivity 0.760, 95% CI 0.631-0.855; specificity 0.803, 95% CI 0.667-0.893). However, suppression of tumorigenesis-2 (ST2) displayed limited diagnostic performance for chronic HFpEF diagnosis (sensitivity 0.636, 95% CI 0.465-0.779; specificity 0.595, 95% CI 0.427-0.743). CONCLUSION: NT-proBNP and BNP appear to be the most reliable biomarkers in chronic HFpEF with NT-proBNP showing higher specificity and BNP showing higher sensitivity. Although Gal-3 appears more reliable than ST2 in HFpEF diagnosis, the conclusions are limited as only three studies were included in this meta-analysis.

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http://hdl.handle.net/10453/152942