Sun R-R, Lu L, Liu M, Cao Y, Li X-C, Liu H, Wang J, Zhang P-Y
Graduate School, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Eur Rev Med Pharmacol Sci. 2014 Oct;18(19):2927-35.
Heart failure (HF) results from the impaired ability of heart to fill or pump out blood. HF is a common health problem with a multitude of causes and affects ~30 million people worldwide. Since ageing is a major risk factor for HF and as several treatment options are currently available to prolong the patients' survival, the number of affected patients is expected to grow. Even though traditional methods of assessment have been in use for managing HF, these are limited by time consuming and costly subjective interpretation and also by their invasive nature. Comparatively, biomarkers offer an objective and biologically relevant information that in conjunction with the patients' clinical findings provides optimal picture regarding the status of the HF patient and thus helps in diagnosis and prognosis. The current gold standard biomarkers for the diagnosis and prognosis of HF are B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP). Additional novel biomarkers (e.g., mid-regional pro atrial natriuretic peptide (MR-proANP), mid-regional pro adrenomedullin (MR-proADM), troponins, soluble ST2 (sST2), growth differentiation factor (GDF)-15 and galectin-3) can potentially identify different pathophysiological processes such as myocardial insult, inflammation and remodeling as the causes for the development and progression of HF. Different biomarkers of HF not only reflect the underlying mechanisms/pathways of HF and also its progression and also point specific therapy options. A multi-biomarker approach for personalized medical care is not too far fetched and such approach can greatly enhance diagnosis, prognostication, and therapy guidance for HF. In this review we describe the current status of HF biomarkers in clinical use and in laboratory research and the efforts aimed at the identification of novel biomarkers for HF.
心力衰竭（HF）是由心脏充盈或泵血能力受损所致。HF是一个常见的健康问题，病因众多，全球约有3000万人受其影响。由于衰老为HF的主要风险因素，且目前有多种治疗方案可延长患者生存期，预计受影响患者数量将会增加。尽管传统评估方法一直在用于HF的管理，但这些方法存在耗时且成本高昂的主观解读局限性，同时还具有侵入性。相比之下，生物标志物可提供客观且具有生物学相关性的信息，结合患者的临床检查结果，能提供有关HF患者病情的最佳情况，从而有助于诊断和预后评估。目前用于HF诊断和预后评估的金标准生物标志物是B型利钠肽（BNP）和N末端前脑钠肽（NT-proBNP）。其他新型生物标志物（如中段心房利钠肽原（MR-proANP）、中段肾上腺髓质素原（MR-proADM）、肌钙蛋白、可溶性ST2（sST2）、生长分化因子（GDF）-15和半乳凝素-3）有可能识别不同的病理生理过程，如心肌损伤、炎症和重塑，这些是HF发生和发展的原因。HF的不同生物标志物不仅反映HF的潜在机制/途径及其进展，还能指出特定的治疗选择。采用多生物标志物方法进行个性化医疗并非遥不可及，这种方法可极大地增强HF的诊断、预后评估和治疗指导。在本综述中，我们描述了HF生物标志物在临床应用和实验室研究中的现状，以及为识别HF新型生物标志物所做的努力。
