Research progress of urinary proteome in heart failure disease

Heart failure (HF) is a disease with a high mortality rate worldwide. HF is classified into HFrEF, HFpEF and HFmrEF based on ejection fraction. Traditional clinical diagnosis relies on BNP/NT-proBNP in blood and imaging examinations, which have problems such as low sensitivity in the early stage and false positives in the late stage. Therefore, it is crucial to discover a non-invasive and feasible biomarker and diagnostic method. This article reviews the pathological mechanism and diagnostic limitations of HF, and focuses on the application and discovery of urine proteomics combined with LC-MS/MS, CE-MS and other mass spectrometry techniques in the screening of HF biomarkers. Among them, urine inflammatory proteins (such as hsCRP and α1-antitrypsin), fibrosis markers (collagen degradation products) and cardiac remodeling molecules (MYL3 and DNASE1) show significant differences among HF subtypes, which can assist in clinical HF classification, prognosis assessment and treatment decision-making. At the same time, urine proteomics provides a new approach for the precise diagnosis and treatment of HF through real-time non-invasive monitoring of pathological changes, and is expected to become a key method for improving prognosis.