1. Comparison of clinical biomarkers in Heart Failure according to sensitivity and specificity
Mostafa Khaled Sedky, Medical Student, Faculty of Medicine-Ain Shams University, Cairo, Egypt.

2. Heart Failure
It is defined as clinical syndrome that results when abnormalities in the structure and function of the myocardium impair cardiac output or decrease filling of the ventricles.
It is a prevailing condition globally and specially in the United States of America. The prevalence of Heart failure cases in America alone has reached 5.8 Million cases, While the global prevalence has reached 23 Million.
Heart failure diagnosis is difficult due to low sensitivity and specificity of clinical signs as dyspnea or orthopnea.

3. Biomarker discovery
Researchers have always tried to find novel biomarkers for the disease with better accuracy including :
Glycosylated chromogranin A
Inducible Nitric Oxide Synthase
Cardiac CRFR1
Chromogranin B
Plasma Galectin 3
Type B Natriuretic peptide

4. Glycosylated chromogranin A
Sample : Blood or heart tissue biopsy if available
Technique : ELISA
Sensitivity : 57%
Specificity : 59%
Normal Range : <3.64 µg/L

5. Glycosylated chromogranin B
Sample : Blood or heart tissue biopsy if available
Technique : ELISA
Sensitivity : 14%
Specificity : 25%
Normal Range : <3.64 µg/L

6. Inducible Nitric Oxide Synthase
Sample : heart tissue biopsy if available
Technique : RT-PCR , Western Blot Analysis , Immunohistochemistry
Sensitivity : 51%
Specificity : 100% in heart tissue biopsy
Normally : Absent

7. Cardiac CRFR 1 Sample : heart tissue biopsy if available
Technique : RT-PCR
Sensitivity : 43%
Specificity : 72%
Normal range : < 50 µg/L RNA

8. Plasma Galectin 3 Sample : Blood Technique : ELISA Sensitivity : 93%
Specificity : 85%
Normal Range : <17.8 µg/L

9. Type B Natriuretic Peptide
Sample : Blood
Technique : fluorescence immunoassay
Sensitivity : 81%
Specificity : 76%
Normal Range : < 300 µg/L

10. Comparison of Sensitivity and Specificity

11. others Decrease in Kv4.3 expression by 30% Clinical Such as :
Orthopnea
Dyspnea

12. Summary Name of The biomarker Sensitivity Specificity Reference
Glycosylated chromogranin A
57%
59%
Ottesen AH, Et al. (2017)
Inducible Nitric oxide synthase
51%
100%
Guy A. Haywood, Et al. (1996)
Cardiac CRFR1
43%
72%
Anna P Pilbrow, Et al. (2016)
Chromogranin B
14%
25%
Helge Røsjø, Et al. (2010)
Plasma Galectin 3
93%
85%
Suarez G, Meyerrose G. (2014)
Type B natriuretic peptide
81%
76%
Mueller C, Et al. (2004)

13. Summary Name of The biomarker Tissue sample Technique
Normal Reference range
Sensitivity
Specificity
Reference
Glycosylated chromogranin A
Blood or Heart
ELISA
<36.4 µg/L
57%
59%
Ottesen AH, Et al. (2017)
Inducible Nitric oxide synthase
Heart
RT-PCR western plot
Immunohistochemistry
0 µg/L
51%
100%
Guy A. Haywood, Et al. (1996)
Cardiac CRFR1
RT-PCR
<50 µg/L RNA
43%
72%
Anna P Pilbrow, Et al. (2016)
Chromogranin B
14%
25%
Helge Røsjø, Et al. (2010)
Plasma Galectin 3
Blood
<17.8 µg/L
93%
85%
Suarez G, Meyerrose G. (2014)
Type B natriuretic peptide
Immuno fluorescence
< 300 µg/L
81%
76%
Mueller C, Et al. (2004)