Biomarkers are surrogate indicators of pathophysiological states of several conditions including heart failure (HF) having various diagnostic potencies and predictive values. Current clinical guidelines reported by American Heart Association and European Cardiology Society have proposed to use advanced medical care for HF patients with diabetes using biomarkers, to diagnose HF and stratify patients at higher risk of poor prognosis, while these biomarkers have demonstrated several limitations among diabetics. Conventional biomarkers of biomechanical stress (natriuretic peptides) had been implemented as a diagnostic and predictive tool for predominantly HF with reduced ejection fraction (HFrEF), but have exhibited controversial results regarding prognostication of clinical outcomes directly related to HF in diabetics treated with sodium-glucose cotransporter (SGLT)-2 inhibitors and glucagon-like peptide (GLP)-1 agonists. The inflammatory biomarkers and biomarkers of fibrosis are not commonly used in routine clinical practice and require evaluation in diabetics with HFrEF and HF with preserved ejection fraction.

The role of the biomarkers, which reflect an activity of co-existing oxidative stress, fibrosis, myocardial hypertrophy and inflammation, are controversial. Non-coding RNAs including small non-coding RNAs (microRNAs, circular RNAs, and long non-coding RNAs), which are regulators insulin resistance, cardiomyocytes apoptosis, and microvascular inflammatory, myocardial hypertrophy, have been critically evaluating especially around their protective effect on cardiac function. Novel biomarkers (adipocytokines, matrix metalloproteinases and their tissue inhibitors, vascular endothelial growth factor, collagen degradation products) are deeply discussed in the context of risk stratification on diabetics with various HF phenotypes. Multiple biomarker predictive strategies will be considered as a promising tool to improve point-of-care amid diabetics with HF during treatment with new antidiabetic drugs.

The goal of this Special Issue is to unveil new perspectives for screening, diagnosis, stratification, and prediction of heart failure in diabetics using biomarkers. Original research and reviews are welcome to clearly elucidate the importance of different biomarkers in heart failure among diabetics.

Potential topics include but are not limited to the following:

• Current biomarker-based risk assessment in diabetics with heart failure
• Natriuretic peptides in heart failure patients with known diabetes mellitus
• Inflammatory biomarkers in diabetics with various phenotypes of heart failure
• Functions and underlying mechanisms of non-coding RNAs in diabetes cardiomyopathy
• Adipocytokines in diabetics with heart failure
• Genes predictive score in heart failure
• Promising biomarkers for ameliorating prognostication in diabetes mellitus cardiomyopathy
• Future in biomarker-based predictive models in heart failure patients treated with antidiabetic drugs