Introduction

Cardiovascular Diseases (CVDs), particularly chronic heart failure, pose a significant threat to numerous patients globally. Due to its gradual progression and intricate origins, effectively screening, diagnosing, and prognosing it presents considerable challenges. Clinical biomarkers and biosensor technologies offer rapid screening and diagnostic capabilities. Various biomarkers serve screening, precise diagnostic, and treatment monitoring purposes. This paper furnishes an updated overview of biomarkers linked to the six primary pathways of heart failure etiology. Plasma natriuretic peptides (BNP and NT-proBNP) and cardiac troponins (cTnT, cTnI) remain pivotal markers for heart failure diagnosis. Supplementary biomarkers include Growth DifferentiationFactor 15 (GDF-15), circulating Galactose Lectin 3 (Gal-3), Soluble Interleukin (sST2), C-Reactive Protein (CRP), and Tumour Necrosis Factor-alpha (TNF-α). Electrochemical biosensors for these biomarkers demonstrate adequate sensitivity, detection limits, and specificity. This review systematically synthesizes the most recent molecular biomarkers and sensors pertinent to heart failure, offering comprehensive and state-of-the-art scientific insights for biomedical and electronic-sensing researchers in the field, as well as patients. Furthermore, our proposed future perspectives may stimulate novel research endeavors for investigators.

Cardiovascular disease

Cardiovascular disease poses a significant threat to the lives of countless individuals globally. Particularly in the wake of the COVID-19 pandemic, there has been a notable surge in the number of cardiovascular patients directly attributed to the virus, coupled with a reduction in treatment and prevention measures for cardiovascular diseases indirectly impacted by the pandemic. This has emerged as a critical public health concern in numerous countries. Presently, we find ourselves in a state of cardiovascular emergency. This presents a significant challenge for both clinical medicine and patients alike. Heart failure encompasses a spectrum of complex clinical syndromes stemming from structural and functional abnormalities in the heart, leading to compromised ventricular systolic and diastolic functions. It stands as a leading cause of hospitalizations and mortality among cardiovascular patients, often regarded as the final battleground in the realm of cardiovascular health. Its clinical manifestations include dyspnea, fatigue, and fluid retention. With the global population aging and the prevalence of chronic conditions like coronary heart disease and hypertension on the rise, there has been a notable uptick in the incidence of heart failure. Despite advancements in medical interventions and treatments, the survival rates post heart failure diagnosis remain disappointingly low. The current worldwide estimate suggests approximately 60 million individuals are living with heart failure, a figure exacerbated by factors such as aging demographics, increased burden of comorbidities, and prolonged survival post-myocardial infarction.

Traditional approaches

The origin of heart failure involves a variety of factors, and the disease typically advances slowly over time. Traditional approaches to screening and diagnosing heart failure often rely on sophisticated laboratory equipment and trained personnel, which can be expensive and inconvenient for patients. However, the adoption of biomarkers and biosensors has presented a solution to this challenge. Biomarkers serve as objective indicators that assess normal or pathological processes, gauge responses to medical interventions, and predict outcomes. These biomarkers may manifest as molecules present in bodily fluids or through physical tissue measurements. Conversely, biosensors are devices designed to identify and measure biomarkers in samples using specific recognition elements. The amalgamation of biomarkers and biosensors has found widespread utility in medicine, facilitating swift disease screening and diagnosis. In the context of heart failure, numerous biomarkers have been identified and scrutinized, offering valuable insights into disease progression and treatment guidance. Recent studies have concentrated on refining biosensors to accurately detect and quantify these biomarkers. This article endeavors to meticulously review the latest research on biomarkers and biosensors for heart failure, synthesizing insights from recent literature and incorporating cutting-edge research in the field. By providing an extensive overview of key biomarkers and sensors pertinent to heart failure, this article enriches existing knowledge and underscores the potential applications of biomarkers and biosensors in diagnosing and managing heart failure.