New Biomarker Panel to Improve Heart Failure Diagnosis in Women

Although heart failure broadly means the heart cannot pump enough blood to the body’s cells, its two main forms—heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)—behave differently and require different treatments. HFpEF, the most common type and particularly prevalent in older women, remains the hardest to diagnose. While biomarkers exist for HFrEF, no reliable biomarkers currently help clinicians distinguish between the two forms. Researchers are now exploring whether small molecules in the blood could serve as indicators of heart failure type and make it easier to detect the condition in women.

In the research being led by the Institute for Experimental Medical Research (Oslo, Norway), the team is investigating the diagnostic potential of circulating microRNAs—tiny RNA molecules that reflect gene expression and may provide insight into disease severity. Their approach centers on identifying microRNAs that differentiate not only between healthy individuals and patients with heart failure, but also between the two major subtypes. Through their research, they discovered a panel of four microRNAs capable of making these distinctions with meaningful accuracy, including markers particularly relevant for women.

The researchers examined whether these microRNAs could serve as indicators of heart failure type. They found that the panel effectively separated HFpEF and HFrEF patients, and also showed strong relevance for women, who are disproportionately affected by HFpEF. In addition to diagnosis, the team showed that these molecules could predict complications such as hospitalizations, readmissions, and heart-related deaths.

Since heart failure is the leading cause of hospitalizations worldwide—with more than half of patients readmitted within six months—the potential impact of such biomarkers is significant. They also highlighted the alarming long-term outlook associated with heart failure, including a mortality rate of 60 percent within five years of diagnosis.

The researchers plan to further validate these microRNA panels in diverse patient groups to ensure the robustness of their findings. They are also exploring whether additional types of biomarkers—from proteins and genetic markers to imaging and laboratory analyses—can be incorporated to create multimodal diagnostic panels for broader clinical use, including in patients with heart or liver transplants. These efforts aim to support more accurate, sex-specific diagnoses and ultimately better treatment strategies for individuals with heart failure.

“We need to differentiate between the two types of heart failure so that we can provide accurate diagnoses to patients and, consequently, the most effective treatment,” said IEMR’s Reza Parvan. “Considering that the majority of HFpEF patients are women and this is the most common form of heart failure among the elderly, this is an important advancement.”

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