Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
Pathology. 2012 Feb;44(2):129-38. doi: 10.1097/PAT.0b013e32834e786e.
The increasing importance of cardiac disease has generated an interest in improved screening strategies regarding preclinical cardiac abnormalities and employing measurement of circulating biomarkers. This review focuses on the utility of the B-type natriuretic peptides (NP) and the cardiac troponins (cTns) for this purpose.
Both the NPs and the cTns are closely related to cardiac structural and functional abnormalities that may progress to symptomatic heart disease, e.g., left ventricular (LV) hypertrophy, LV systolic and diastolic dysfunction. Both biomarkers provide incremental information to each other. However, biomarker results may be confounded by several non-cardiac conditions, and decision thresholds and recommendations on further clinical work-up are as yet not specified. Furthermore, cost issues will probably preclude widespread biomarker screening in general populations.
Measurement of the NPs or cTns is an attractive option for screening for cardiac abnormalities. This may be particularly effective in patients at higher risk for developing overt heart disease. Nevertheless, appropriate diagnostic and therapeutic responses to biomarker results need to be defined before routine screening can be recommended in the community setting.
心脏病的重要性日益增加，这促使人们关注改进针对临床前心脏异常的筛查策略，并采用循环生物标志物测量。本文重点介绍 B 型利钠肽（NP）和心肌肌钙蛋白（cTn）在这方面的应用。
NP 和 cTn 都与可能进展为有症状心脏病的心脏结构和功能异常密切相关，例如左心室（LV）肥厚、LV 收缩和舒张功能障碍。这两种生物标志物彼此提供额外的信息。然而，生物标志物的结果可能会受到多种非心脏疾病的影响，目前尚未确定进一步临床评估的决策阈值和建议。此外，成本问题可能会使生物标志物的广泛筛查在一般人群中无法实现。
测量 NP 或 cTn 是筛查心脏异常的一种有吸引力的选择。对于有发展为显性心脏病风险较高的患者，这种方法可能特别有效。然而，在推荐在社区环境中进行常规筛查之前，需要确定对生物标志物结果的适当诊断和治疗反应。
