Adverse cardiac remodeling is defined as changes in cardiac structure, altered geometry, and impaired cardiac cell architectonic and weak function due to acute and/or chronic cardiac injury. Recent clinical trials have shown that adverse cardiac remodeling is characterized by prolonged hospitalizations, increased need for readmission due to heart failure occurrence, and higher cardiovascular mortality rate. The majority of cases associated with the development of adverse cardiac remodeling are caused by acute coronary syndrome (ACS) or acute myocardial infarction and are rarely from nonischemic reasons (cardiomyopathies, hypertension, arrhythmia, myocarditis, and acquired and congenital heart disease).

The clinical guidelines for heart failure reported by the European Society of Cardiology (ESC) and the American Heart Association (AHA) state that embedded cardiac biomarkers should be used for risk stratification, diagnosis, and prognosis for clinical outcomes. Natriuretic peptides, galectin-3, soluble suppressor of tumorigenicity receptor-2, and cardiac troponins are all recommended for these purposes by the AHA, while the ESC recommends natriuretic peptides for diagnostic and predictive values, which are considered biomechanical stress biomarkers. Although there is a wide range of other biomarkers with established predictive value for cardiac remodeling in heart failure, not all of them have a proven predictive value for survival among patients with heart failure. Biomarkers (such as cardiac troponins, creatine kinase, and myoglobin) of necrosis are recommended by clinical guidelines for diagnosis of acute myocardial infarction and risk stratification in acute coronary syndrome, but there is evidence that their predictive value is lower than biomechanical stress biomarkers, such as natriuretic peptides. In fact, traditional biomarkers frequently exhibit lower sensitivity and specificity and so cannot be used widely in routine clinical practice with an aim to stratify patients at risk of cardiac remodeling and predict poor prognosis. In this context, discovery of new reliable noninvasive predictive biomarkers for adverse cardiac remodeling appears to be promising.

This special issue aims to collect both original research and review articles on the topic of circulating (both old and new biomarkers) and imaging biomarkers that could stratify patients at risk to adverse cardiac remodeling. The issue also aims to present new biomarker-based models that could be effective in the prediction of major cardiovascular events relating to adverse cardiac remodeling. Submissions are encouraged that discuss new circulating biomarkers such as single nucleotide polymorphisms (SNPs), micro-RNA, matrix metalloproteinases, vascular endothelial growth factors, degradation collagen products, number and function of endothelial/mesenchymal progenitor cells, and apoptotic cell-derived microvesicles. Submissions that consider these in the context of adverse cardiac remodeling prediction, heart failure risk stratification, and optimal biomarker-guided therapy are also welcomed.

Potential topics include but are not limited to the following:

• Conception and clinical implementation of biomarker-based risk assessment in heart failure
• Optimal choice of time window for biomarker measurement in heart failure
• Natriuretic peptides in heart failure
• Soluble ST2 or galectin-3 in heart failure
• MicroRNAs signature in adverse cardiac remodeling and heart failure
• SNPs within genes in adverse cardiac remodeling
• Diagnostic and predictive importance of SNPs in genes that are involved in the pathogenesis of heart failure
• Progenitor cells as novel biomarkers for risk stratification in heart failure
• Microvesicles in heart failure: diagnostic and predictive value
• Gene card in heart failure
• Novel biomarkers for heart failure risk stratification
• Biomarker-guided therapy for heart failure
• Biomarkers and surrogate endpoints in randomized clinical trials
• Future of biomarker-based predictive models in adverse cardiac remodeling