The detection of cardiovascular biomarkers in dermal interstitial fluid - a step to real-time monitoring

Cardiovascular biomarkers are central to the diagnosis and management of a range of acute and chronic disease states, yet current approaches remain dependent on episodic venous blood sampling. Dermal interstitial fluid (ISF), a dynamic and accessible biofluid, offers a promising alternative for continuous and minimally invasive biomarker monitoring. In this Review, we explore the emerging convergence of ISF biosensing technologies with cardiovascular diagnostics. We discuss the physiological basis of ISF sampling and highlight engineering advances in microneedle arrays, hydrogel implants and electrokinetic extraction methods. We examine state-of-the-art biosensing platforms—ranging from enzymatic electrochemical sensors to aptamer- and antibody-based systems—and evaluate their applicability to key cardiovascular biomarkers, including troponin, natriuretic peptides, CRP and microRNAs. Although early studies demonstrate proof-of-concept for ISF-based detection of several cardiac biomarkers, clinical translation remains limited. While still in proof of concept stage, continuous ISF monitoring could disrupt traditional models of care by enabling earlier detection, personalised risk stratification and remote disease management. However, it also presents challenges related to clinical workflow integration, data interpretation and regulatory oversight. Bridging these gaps will require multidisciplinary innovation across materials science, device engineering and clinical validation. By transitioning from episodic blood sampling to continuous dermal monitoring, this technology promises to redefine cardiovascular care; shifting the paradigm from reactive acute management to proactive, personalised, and predictive precision medicine.