Currently, natriuretic peptides like BNP are the most commonly analyzed markers for diagnosing heart failure in patients. BNP levels also provide some information on prognosis and associated risk stratification in these patients. Heart failure, however, is a complex clinical syndrome, likely caused by dysfunction in multiple pathways. Therefore, the analysis of more than one biomarker may be very beneficial in establishing more accurate prognosis, diagnosis, and response to therapy in heart failure patients. 

The investigators have established, in a large cohort of heart failure patients, that circulating neuregulin-1beta is independently associated with heart failure severity and transplant-free survival. They have also shown that the association of adverse outcomes tied to circulating neuregulin-1beta levels was independent of BNP levels.  Patients with chemotherapy-induced cardiotoxicity have significantly lower amounts of neuregulin-1beta in circulation.  This biomarker may therefore offer powerful diagnostic, prognostic and risk-stratification benefits in heart failure patients as well as in cases of chemotherapy-induced cardiotoxicity.