Division of Cardiology, Department of Medicine, Medical University of South Carolina and Ralph H. Johnson, Ashley River Towers, 25 Courtenay Drive, Charleston, SC 29425, USA.
J Cardiovasc Transl Res. 2013 Aug;6(4):501-15. doi: 10.1007/s12265-013-9472-1. Epub 2013 May 29.
Comprehensive diagnostic criteria, accurate prognostic indicators, and effective treatment for patients with heart failure and a preserved ejection fraction (HFpEF) represent a critically important unmet need in cardiovascular medicine. Novel approaches to fill this unmet need are likely to be facilitated by targeting the underlying and unique pathophysiologic mechanisms that characterize patients with HFpEF. Two possible targets include hemodynamic overload evidenced by increased LV diastolic pressure (LVDP) and myocardial fibrosis evidenced by increased extracellular matrix fibrillar collagen. The measurement of LVDP and fibrosis generally requires either invasive procedures and/or complex and sophisticated imaging techniques. However, biomarkers measured in the plasma have been shown to accurately reflect changes in hemodynamic load and myocardial fibrosis and may have important application to the management of patients with HFpEF. The purpose of this review is to describe current and future applications of biomarkers in the management of patients with HFpEF.
对于射血分数保留的心力衰竭（HFpEF）患者，综合诊断标准、准确的预后指标和有效治疗方法是心血管医学中一个极其重要但尚未满足的需求。通过针对 HFpEF 患者特有的潜在病理生理机制，可能会找到满足这一需求的新方法。两个可能的目标包括：由左心室舒张末期压力（LVDP）增加引起的血流动力学过载和由细胞外基质纤维状胶原蛋白增加引起的心肌纤维化。LVDP 和纤维化的测量通常需要侵入性程序和/或复杂和先进的成像技术。然而，在血浆中测量的生物标志物已被证明能准确反映血流动力学负荷和心肌纤维化的变化，并且可能对 HFpEF 患者的管理具有重要应用价值。本文旨在描述生物标志物在 HFpEF 患者管理中的当前和未来应用。
