Circulating Biomarkers in Elderly Patients with Heart Failure: A Real-Life Study

BACKGROUND: Heart failure (HF) is a clinical syndrome that involves multiple interconnected pathways. Circulating biomarkers in HF emerged as powerful tools for risk stratification, diagnostic confirmation, prognostic assessment, and monitoring of treatment efficacy. The aim of the present study was to evaluate circulating levels of biomarkers in elderly patients with HF improved ejection fraction, previously with left ventricular ejection fraction (LVEF) <40%, after 6 months of drug therapy optimisation. METHODS: We enrolled 100 HFimpEF outpatients. All patients underwent medical history and physical examination, at the baseline and after 6 months of follow-up. The serum values of circulating biomarkers were assessed with ELISA test. Proteomic analysis was performed on serum samples collected from a subset of 13 patients at baseline and after 6 months of follow-up. RESULTS: At follow-up, we observed significant improvements in glycometabolic, renal and inflammatory profile (p<0.001). Proteomic analysis revealed selective changes in key cardiovascular (CV)-related proteins, such as Insulin-like growth factor-binding protein 4 (IBP4) Thrombospondin4 (TSP4), Intercellular adhesion molecule 1 (ICAM1), Syndecan-4 (SDC4). CONCLUSIONS: This study demonstrates significant improvements across multiple CV biomarkers, after 6 months of therapy optimization, in HFimpEF patients, providing evidence for comprehensive therapeutic effects targeting inflammation, oxidative stress, neurohormonal activation, and thrombotic risk.