Biomarkers and Heart Rate Variability in the Prognosis of Cardiovascular Disease: A Perspective

The cholesterol level, risk factors, cellular events including calcification and inflammation lead to the formation of atherosclerosis plaque. The deposited plaque leads to baroreflex impairment that narrows the blood vessels resulted in catastrophic clinical manifestation of cardiovascular diseases (CVDs). The severity of plaque is influenced by the risk factors. In the prognosis of atherosclerosis events, various biomarkers play an important role such as interleukin-6 (IL-6), C-reactive protein (CRP), low-density lipoprotein (LDL) levels and tumor necrosis factor-α (TNF-α), and many more. C-reactive protein (CRP) has suggested predicting cardiovascular events. The atherosclerosis progression has also been associated with an elevated heart rate (HR) with the relationship between heart rate and arterial stiffness. However, the exact role of the CRP assay for treatment decisions has not been fully established and the identification of such biomarkers is the ongoing quest that can predict the cardiovascular risk. Further, there has been little evidence of an association between HR and its variability with coronary atherosclerosis. Thus, measurement of heart rate variability (HRV) indexed to biomarker as an established measure of autonomic function, may offer additive predictive information and identify the risk factors of CVDs progression.