Potocki Mihael, Ziller Ronny, Mueller Christian
Department of Cardiology, University Hospital, Petersgraben 4, 4031, Basel, Switzerland.
Curr Heart Fail Rep. 2012 Sep;9(3):244-51. doi: 10.1007/s11897-012-0096-6.
Circulating biomarkers have become increasingly important in diagnosing and risk-stratifying patients with heart failure (HF). While the natriuretic peptides have received much focus in the past decade, there is increasing interest in the role of other circulating biomarkers such as mid-regional proadrenomedullin (MR-proADM), a stable peptide of the precursor of adrenomedullin (ADM), responsible for volume regulation and electrolyte homeostasis. Increased levels of MR-proADM are associated with an increased risk of mortality and morbidity in patients with HF, independent of natriuretic peptides. MR-proADM outperforms all other established markers in the identification of patients at highest risk of death, particularly death within 30 days. The prognostic superiority has consistently been shown for various cardiovascular disease states, including acute heart failure. In this article, we discuss the potential role of MR-proADM in the syndrome of acute heart failure and its implication on prognosis and risk stratification.
循环生物标志物在心力衰竭（HF）患者的诊断和风险分层中变得越来越重要。虽然利钠肽在过去十年中备受关注，但人们对其他循环生物标志物的作用越来越感兴趣，比如中段肾上腺髓质素原（MR-proADM），它是肾上腺髓质素（ADM）前体的一种稳定肽，负责容量调节和电解质平衡。MR-proADM水平升高与HF患者的死亡和发病风险增加相关，且独立于利钠肽。在识别死亡风险最高的患者，尤其是30天内死亡的患者方面，MR-proADM优于所有其他已确立的标志物。对于包括急性心力衰竭在内的各种心血管疾病状态，其预后优势一直得到证实。在本文中，我们讨论了MR-proADM在急性心力衰竭综合征中的潜在作用及其对预后和风险分层的影响。
