Personalized risk assessment of heart failure patients: More perspectives from transforming growth factor super-family members

•Personalized risk assessment of patients with heart failure (HF) is important.•Biomarkers can contribute to the sub-phenotyping of HF patients.•Transforming growth factor β (TGF-β) members contribute to cardiac remodeling.•TGF-β member testing can guide HF prognostication and therapeutic selection.

More personalized risk assessment of patients with heart failure (HF) is important to develop more tailored based care and for a better allocation of resources. The measurement of biomarkers is now part of the standards of care and is important for the sub-phenotyping of HF patients to demonstrate the activation of pathophysiological pathways engaged in the worsening of HF. The sub-phenotyping of patients can lead therefore to a more personalized selection of the treatment. Several members of the transforming growth factor β (TGF-β) super-family, such as myostatin, activin A, GDF-15 and GDF-11, are involved in cardiac remodeling and the evaluation of their circulating levels might provide new insights to the course of the disease and also to guide prognostication and therapeutic selection of HF patients.