Biomedical Engineering Reference
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treatment. Several biomarkers of CHF overlap with those of other cardiovascular
disorders as several pathologies are in operation when the heart fails. Some of these
biomarkers have already been discussed under other disease categories.
Angiogenesis Biomarkers
Patients with CAD and left ventricular systolic dysfunction (LVSD) are often
asymptomatic. Angiogenesis is implicated in the physiology of vascular repair
and cardiac remodeling, and is one of many pathophysiological processes impli-
cated in heart failure. Plasma indices associated with angiogenesis - angiogenin,
vascular endothelial growth factor (VEGF), and angiopoietin (Ang)-1 and Ang-2 -
are hypothesized to be abnormal in CAD patients with LVSD, being correlated
with EF and wall motion abnormalities wall motion score independently of under-
lying coronary atheroma score. However, study results show that levels of angio-
genin are inversely related with EF and positively with coronary atheroma scores,
but not independently of EF (Patel et al.
2009
). Other angiogenic markers were
unrelated to objective measures of LVSD but VEGF were lower amongst those
patients with heart failure. Angiogenin levels were related to wall motion scores.
Thus, heart failure has only a modest impact on biomarkers of angiogenesis, in
patients with CAD. Further research is warranted into the diagnostic and prognos-
tic utility of biomarkers of angiogenesis for detection of asymptomatic ventricular
dysfunction.
Beta-2a Protein as a Biomarker of Heart Failure
Increased activity of single ventricular L-type Ca
2+
channels (L-VDCC) is a hall-
mark in human heart failure. Calcium plays a key role in controlling heart beat and
this calcium ion channel is regulated by a group of accessory proteins, a major
component of which is the beta-2a regulatory protein. In many types of terminal
human heart failure beta-2a protein is increased or overexpressed, and the electrical
activity in the heart's cells show a distinct pattern of single-channel activity, an
indicator that the influx of calcium into the heart has also increased (Hullin et al.
2007
). In a mouse model with an overexpressed beta-2a protein, the heart received
a sustained increase of calcium, and slowly became hypertrophied and eventually
failed. All the changes in the animal model - biochemical, physiological, and
pathological - resembled the human heart failure process. This finding shows the
potential values of beta-2a as a biomarker of heart failure and provides the thera-
peutic possibility to lower beta-2a in a heart that is beginning to fail.
Desmin
Desmin is one of the fundamental cytoskeleton proteins of cardiomyocytes, and has
a mechanical, structural, and regulatory function. In comparison with healthy indi-
viduals, patients with heart failure (HF) present different expression of desmin
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