Bielecka-Dabrowa Agata, Wierzbicka Magdalena, Dabrowa Marek, Goch Aleksander
1st Department of Cardiology and Cardiosurgery, Medical University, Łódź, Poland.
Cardiol J. 2008;15(4):388-95.
Dilated cardiomyopathy (DCM) is a multifactorial heart disease in which there is enlargement and systolic dysfunction of one or both ventricles. The exhaustion of compensatory mechanisms leads to symptoms of congestive heart failure, which is a significant problem in contemporary cardiology. DCM is still diagnosed using clinical assessment; echocardiography is necessary, and in some clinical situations we need hemodynamic assessment in order to identify the etiology and progression of heart disease. These tests are necessary for choice of treatment and qualification for heart transplant. Investigators are looking for new, valuable, additional parameters which could be of use in screening and heart disease progression assessment, and which may be helpful in the management and risk stratification of patients with DCM. These monitoring and prognostic tools in patients with chronic heart failure can be biomarkers, such as natriuretic peptides: BNP and NT-proBNP, cardiac troponins or inflammatory cytokines and their receptors. Moreover, there are ongoing research projects concerning persistently elevated uric acid, Ca-125 and osteopontin concentrations for the identification of patients with DCM, as well as adverse prognoses.
扩张型心肌病（DCM）是一种多因素心脏病，其中心脏一个或两个心室出现扩大和收缩功能障碍。代偿机制的耗竭会导致充血性心力衰竭症状，这是当代心脏病学中的一个重大问题。DCM仍通过临床评估进行诊断；超声心动图是必要的，在某些临床情况下，我们需要进行血流动力学评估以确定心脏病的病因和进展。这些检查对于选择治疗方法和确定心脏移植资格至关重要。研究人员正在寻找新的、有价值的额外参数，这些参数可用于筛查和评估心脏病进展，并且可能有助于DCM患者的管理和风险分层。慢性心力衰竭患者的这些监测和预后工具可以是生物标志物，如利钠肽：脑钠肽（BNP）和N末端脑钠肽原（NT-proBNP）、心肌肌钙蛋白或炎性细胞因子及其受体。此外，正在进行有关持续升高的尿酸、Ca-125和骨桥蛋白浓度的研究项目，以识别DCM患者以及不良预后。
