## 2 Precision Medicine and Cardiology
### Heart Failure
#### 2.3.2 Proteomics  
[PERSON] found that among older adults without HF with initially low cardiac troponin T(cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP), the long-term trajectory of both biomarkers predicts systolic dysfunction, incident HF, and CV death [93]. [PERSON] et al. defined that copeptin predicted 5-year all-cause mortality in heart failure patients. [PERSON] et al., found that plasma TB4 is elevated in women with HFpEF, which predicts mortality independent of clinical risk factors and NT-proBNP in women with HF [92]. [PERSON] et al. found that \(\beta\)-endorphin (\(\beta\)-EP) and brain natriuretic peptide BNP have both high specificity and sensitivity to detecting early acute left heart failure and atrial fibrillation in patients [89]. [PERSON] et al., investigated the effects of spironolactone on the serum markers of collagen metabolism and cardiovascular structure and function in people at risk of developing HF, as well as the potential interactions with a marker of  
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**S.N.** & **Authors** & **Year** & **Study Design** & **Clinically Relevant Findings** & **Comments** & **References** \\ \hline
18 & [PERSON] et al. & 2014 & Original Study & 3-hydroxybutyrate, acetone, and succinate, were significantly elevated in patients with HFrEF. & Patients with HFrEF had higher levels of & \\
19 & [PERSON] et al. & 2013 & Original Study & Lactate, alanine, creatinine, proline, isoleucine, and leucine in plasma. & Levels of lactate, alanine, creatine, proline, isoleucine, and leucine in plasma were all greater in patients with ischemic HFrEF compared to healthy controls. & [100] \\ \hline
20 & [PERSON] et al. & 2013 & Original Study & Plasma lactate and total cholesterol. & Patients with acute decompensated HF who have a high ratio of plasma lactate to total cholesterol have a significantly higher risk of dying within 30 days (ADHF). & [101] \\ \hline MICROBIOMICS & & & & & \\ \hline
21 & [PERSON] et al. & 2014 & Original Study & Trimethylamine N-oxide (TMAO). & Increased mortality risk over the long run was associated with elevated TMAO levels. & [102] \\ \hline \hline \end{tabular}
\end{table}
Table 4: _Cont._fibrogenic activity, galectin-3 [88]. [PERSON] found that Hs-cTnT was elevated in the majority of acute heart failure (AHF) patients. Baseline, peak, and peak change hs-cTnT were associated with worse outcomes, mainly 180-day cardiovascular mortality [91]. [PERSON] et al. found that MR-proANP seems accurate in diagnosing acute decompensated heart failure (ADHF), whilst both mid-regional pro-atrial natriuretic peptide (MR-proANP) and mid-regional pro-adrenoromedullin (MR-proADM) acclimatize prognosis [50]. [PERSON] found that growth differentiation factor 15 (GDF) levels are increased in patients with HF and correlate with the extent of myocardial fibrosis, hence they are used as a biomarker for cardiac remodeling [95]. [PERSON] et al. found that increased galectin-3 (Gal-3) and N-terminal propeptide III procollagen (PIIINP), and low metallic metalloproteinase metalloproteinase-1 (MMP-1) are associated with adverse long-term heart failure outcomes [96]. [PERSON] et al. suggested that CA125 is a surrogate of fluid overload, hence it is potentially valuable for guiding decongestion therapy, and a CA125-guided diuretic strategy improved eGFR in patients with acute heart failure with renal dysfunction [87]. [PERSON] et al. found that the soluble suppression of tumorigenesis (sST2) measurement identifies patients with chronic heart failure in whom higher beta-blocker doses may be beneficial [94].