{
  "abstract": "Background: Saliva has been proposed as a non-invasive biological matrix for cardiovascular biomarker assessment. However, evidence regarding its agreement with blood-based measurements in patients with heart failure remains inconsistent. Objective: To assess the presence of NT-proBNP, troponin, and high-sensitivity C-reactive protein in saliva and their correlation with serum concentrations in patients with heart failure over a six-month follow-up period. Methods: Participants were prospectively evaluated, and paired saliva and blood samples were collected at baseline, 3 and 6 months. The population included 52 individuals (30 males and 22 females) with HFmrEF (LVEF 41–49%) or HFrEF (LVEF ≤40%), aged 49–80 years (mean age of 61.1 ± 6.79 years). Biomarker concentrations were measured in both matrices. Agreement between salivary and serum measurements was assessed using Bland–Altman analysis. Additional analyses explored whether age influenced the relationship between salivary and serum biomarker levels. Results: All three biomarkers were consistently detectable in whole saliva. However, Bland–Altman analyses showed that salivary NT-proBNP and troponin did not demonstrate clinically acceptable agreement with serum concentrations at any evaluated time point, indicating limited interchangeability between matrices. In contrast, hs-CRP exhibited relatively better agreement between saliva and serum, with mean bias close to zero and moderate limits of agreement, although substantial inter-individual variability persisted. Age and sex did not meaningfully influence the relationship between salivary and serum biomarker concentrations. Conclusions: Although NT-proBNP, troponin, and hs-CRP are detectable in saliva, salivary measurements of NT-proBNP and troponin showed insufficient agreement with serum levels to support their use as substitutes for blood-based assessment in heart failure. hs-CRP demonstrated comparatively better performance but remains limited by variability. Under the conditions evaluated, serum remains the reference standard for cardiovascular biomarker assessment in heart failure, and saliva should be regarded as a matrix warranting further investigation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, University of Taubaté, Taubaté, São Paulo, Brazil",
    "Department of Dentistry, University of Taubaté, Taubaté, São Paulo, Brazil",
    "Department of Clinical Sciences, Pathology, and Surgery, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil",
    "School of Nursing and Public Health, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil",
    "CEEpiRG - Center for Epigenetic Study and Genic Regulation, Program in Environmental and Experimental Pathology, Paulista University, São Paulo, São Paulo, Brazil"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ruy Felipe Melo Viegas"
    },
    {
      "affs": [
        1
      ],
      "name": "Sheila Cavalca Cortelli"
    },
    {
      "affs": [
        2
      ],
      "name": "Davi Romeiro Aquino"
    },
    {
      "affs": [
        3
      ],
      "name": "Fernando Oliveira Costa"
    },
    {
      "affs": [
        4
      ],
      "name": "Bruna Hentges"
    },
    {
      "name": "Vitórya Carvalho Pádua de Magalhães"
    },
    {
      "name": "Rodrigo Augusto Foganholi Silva"
    },
    {
      "name": "Gilson Fernandes Ruivo"
    },
    {
      "name": "Jose Roberto Cortelli"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e6kh00wbea0jw.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0357206",
  "fulltext_url": null,
  "id": "e6kh00wbea0jw",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0357206",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Heart Failure Treatment and Management"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Body fluids/Blood"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Body fluids/Saliva"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Biomarkers"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Proteins/Cytoskeletal proteins/Troponin"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Body fluids/Blood"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Body fluids/Saliva"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Body fluids/Blood"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Body fluids/Saliva"
    ],
    [
      "plos",
      "/Medicine and health sciences/Cardiology/Ejection fraction"
    ],
    [
      "plos",
      "/Medicine and health sciences/Cardiology/Heart failure"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pharmaceutics/Drug therapy/Receptor antagonist therapy"
    ],
    [
      "plos",
      "/Research and analysis methods/Immunologic techniques/Immunoassays/Enzyme-linked immunoassays"
    ]
  ],
  "openalex": "W7213543606",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357206&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-18",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/e6kh00wbea0jw.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:49Z",
      "native_id": "10.1371/journal.pone.0357206",
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      "url": "https://doi.org/10.1371/journal.pone.0357206"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
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  "title": "Salivary and serum levels of NT-proBNP, troponin, and high-sensitivity C-reactive protein in patients with heart failure",
  "title_text": "Salivary and serum levels of NT-proBNP, troponin, and high-sensitivity C-reactive protein in patients with heart failure",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:49Z",
  "url": "https://research.draconitic.com/paper/e6kh00wbea0jw",
  "venue": "PLOS One",
  "versions": []
}