Biomarkers of Heart Failure in Myocarditis and Dilated Cardiomyopathy

There are many reviews that discuss the role of biomarkers in cardiovascular disease (CVD) and heart failure (Braunwald, 2008; Chen et al., 2010; Hochholzer et al., 2010), but little information exists regarding the presence and usefulness of biomarkers for heart failure in myocarditis and dilated cardiomyopathy (DCM) patients. Heart failure (HF) is the end consequence of many CVDs including atherosclerosis, myocardial infarction, myocarditis and DCM. CVD is the leading cause of morbidity and mortality in Western nations (Roger et al., 2011), and a growing concern worldwide (Gaddam et al., 2011). As treatments for CVD prolong survival, the prevalence of chronic HF has increased. It is now estimated that 5.8 million people in the United States live with HF and over 23 million worldwide (Bui et al., 2011). Approximately 550,000 new cases of HF are diagnosed each year, with a lifetime risk for developing disease of one in five (Chen et al., 2010; Krumholz et al., 1997). Hospitalizations for HF have also increased dramatically in the United States from 402,000 in 1979 to 2.4 million in 2007 with the cost of treating HF patients estimated at $39 billion annually (Bui et al., 2011; Chen et al., 2010; Roger et al., 2011). Biomarkers have become an increasingly important clinical tool for assessing CVD and progression to HF. Biomarkers are used in early detection of sub-clinical disease, diagnosis, risk stratification, monitoring disease state, and to determine therapies (Hochholzer et al., 2010). Many biomarkers are also risk factors directly involved in the pathogenesis of disease.