Blood Samples May Reveal Key Clues About Heart Failure
A simple blood test could increasingly provide doctors with valuable information about what is happening inside a weakened heart. Researchers are studying a growing number of blood-based biomarkers to better understand heart failure, identify patients at greater risk of complications, and potentially improve the personalization of treatment.
Heart failure occurs when the heart can no longer pump enough blood to meet the body’s needs effectively. The condition can develop gradually, and symptoms such as shortness of breath, fatigue, and swelling in the legs may sometimes be mistaken for normal signs of aging or attributed to other medical conditions.
What can blood tests reveal?
Blood contains numerous molecules that reflect the condition of different organs. Some can indicate increased stress on the heart, inflammation, fibrosis, or structural changes in the cardiac muscle.
Among the biomarkers already used in clinical practice are BNP and NT-proBNP, two peptides released when the walls of the heart are subjected to increased pressure or stress. These biomarkers play an important role in evaluating patients who may have heart failure.
Recent research, however, is looking beyond individual markers by examining combinations of several biomarkers.
Several biomarkers could provide a more complete picture
A 2026 study published in IJC Heart & Vasculature followed 334 people with moderate to severe chronic heart failure. Researchers analyzed blood samples collected at several time points to examine changes in a range of biomarkers.
Fifteen biomarkers were significantly associated with the combined risk of death from any cause or hospitalization for heart failure. Among the markers showing the strongest associations were MMP-2, ST2, IGFBP-1, IGFBP-7, and NT-proBNP. Their trajectories also appeared to change before some adverse clinical events occurred.
These findings suggest that repeated blood testing could provide more information than a single measurement. Tracking biomarker changes over time may help identify biological changes associated with worsening heart failure.
Biomarkers may also help distinguish different forms of heart failure
Heart failure is not a single condition. It can occur with reduced or preserved ejection fraction, two forms that may involve different underlying biological mechanisms.
A 2026 study published in ESC Heart Failure analyzed 19 plasma biomarkers in patients with heart failure with preserved or reduced ejection fraction. Several of the biomarkers examined showed different patterns depending on the type of heart failure.
This approach could improve understanding of the biological mechanisms involved in different forms of the disease and, in the longer term, contribute to more individualized treatment strategies.
Could a blood test predict complications?
This is one of the most promising areas of research. The goal is no longer simply to determine whether a patient has heart failure, but also to identify those at greatest risk of deterioration.
Recent research suggests that certain blood biomarkers are associated with processes such as cardiac stress, heart remodeling, and fibrosis. Changes in these markers over time could therefore provide clues about how the disease is progressing.
However, biomarkers should not be interpreted on their own. Doctors need to consider them alongside symptoms, physical examination, electrocardiography, echocardiography, and other relevant tests.
Toward more personalized medicine
One of the major goals of this research is to move from an assessment based primarily on symptoms and imaging toward an approach that also incorporates each patient’s biological profile.
Studies using hundreds or even thousands of blood proteins have already attempted to identify combinations capable of predicting the course of heart failure more accurately. Artificial intelligence and proteomic analysis are also being investigated as tools for selecting the most informative biomarkers.
In the future, a combination of biomarkers could potentially help determine which patients require closer monitoring and which may benefit from earlier adjustments to their treatment.
A technology that is still developing
It is important not to suggest that a simple blood test can already replace conventional cardiac investigations. Several biomarkers remain experimental and require validation in larger and more diverse populations before they can become part of routine clinical practice.
Likewise, an elevated biomarker level does not automatically mean that a person has heart failure or that a complication will necessarily occur. Results must always be interpreted in the context of the patient’s overall clinical condition.
Blood samples are opening a new window into heart failure. Biomarkers already provide valuable information about stress on the heart, while newer research is attempting to extract much more detailed information from complex biological profiles.
Monitoring several biomarkers over time could help researchers and clinicians better understand disease progression, identify patients at higher risk of complications, and move toward more personalized care.
The most promising prospect is therefore a future in which a blood test, combined with conventional cardiac examinations, could provide an increasingly precise picture of the heart’s condition and how it is changing over time.
