Cox Liam¹, Howard Eva², Ward Grayson³, Torres Lucy⁴, Peterson Adam⁵, Gray Aurora⁶, Ramirez Leo⁷, James Mila⁸, Watson Owen⁹
ABSTRACT:
Galectin-3 and soluble ST2 (sST2) have emerged as clinically relevant biomarkers in chronic heart failure (HF), reflecting distinct pathophysiological pathways of myocardial fibrosis and mechanical stress. This review compares their prognostic performance across HF phenotypes, analyzing their pathobiological roles in cardiac remodeling, results from head-to-head comparisons in multicenter cohorts, guideline recommendations and established cutoff values, as well as therapeutic implications for biomarker-guided care. We evaluate evidence from over 50 clinical studies, highlighting areas of consensus and controversy in their clinical application.