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Biomarkers in the Diagnosis, Management, and Prognostication of Perioperative Right Ventricular Failure in Cardiac Surgery—Are We There Yet?

1
Divisions of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
2
Cardiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
3
Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada
4
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(4), 559; https://doi.org/10.3390/jcm8040559
Received: 23 February 2019 / Revised: 27 March 2019 / Accepted: 22 April 2019 / Published: 25 April 2019
(This article belongs to the Special Issue Acute and Chronic Heart Failure)
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PDF [272 KB, uploaded 25 April 2019]

Abstract

Right ventricular failure (RVF) is a major risk factor for end organ morbidity and mortality following cardiac surgery. Perioperative RVF is difficult to predict and detect, and to date, no convenient, accurate, or reproducible measure of right ventricular (RV) function is available. Few studies have examined the use of biomarkers in RVF, and even fewer have examined their utility in the perioperative setting of patients undergoing cardiac surgery. Of the available classes of biomarkers, this review focuses on biomarkers of (1) inflammation and (2) myocyte injury/stress, due to their superior potential in perioperative RV assessment, including Galectin 3, ST2/sST2, CRP, cTN/hs-cTn, and BNP/NT-proBNP. This review was performed to help highlight the importance of perioperative RV function in patients undergoing cardiac surgery, to review the current modalities of RV assessment, and to provide a review of RV specific biomarkers and their potential utilization in the clinical and perioperative setting in cardiac surgery. Based on current evidence, we suggest the potential utility of ST2, sST2, Gal-3, CRP, hs-cTn, and NT-proBNP in predicting and detecting RVF in cardiac surgery patients, as they encompass the multifaceted nature of perioperative RVF and warrant further investigation to establish their clinical utility. View Full-Text
Keywords: right ventricular failure; biomarkers; cardiac surgery; natriuretic peptides; Galectin-3; ST2; sST2 right ventricular failure; biomarkers; cardiac surgery; natriuretic peptides; Galectin-3; ST2; sST2
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Jabagi, H.; Mielniczuk, L.M.; Liu, P.P.; Ruel, M.; Sun, L.Y. Biomarkers in the Diagnosis, Management, and Prognostication of Perioperative Right Ventricular Failure in Cardiac Surgery—Are We There Yet? J. Clin. Med. 2019, 8, 559.

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