Papadimitriou Lampros, Kalogeropoulos Andreas P
Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road, NE, Suite 535B, Atlanta, GA 30322, USA.
Curr Med Chem. 2015;22(23):2716-26. doi: 10.2174/0929867322666150415152532.
Improved outcomes of acute cardiac conditions, population aging, prevalent lifestyle-related risk factors, and advances in heart failure (HF) therapy, all have led to an ever-increasing prevalence of HF, currently considered a public health priority in developed countries and a major noncommunicable syndrome in developing regions. Heart failure is a complex syndrome with a host of pathophysiological mechanisms in action. Inflammation, an integral component of homeostasis, is a complex tissue response to stressors that attempts to mitigate their effect and initiate healing. Inflammation plays a critical role in the development, course, severity and outcomes of HF. The delicate balance of pro- and antiinflammatory processes can lead to beneficial or detrimental effects to the failing heart. In this article, we review the evidence on inflammatory biomarkers and their potential role in prognosis and therapeutic decisions for patients with HF. Although attempts to directly disrupt the inflammatory cascade in HF have been largely abandoned due to lack of efficacy and potential harm, there are still important gaps in our knowledge. Despite the strong association of levels of inflammatory biomarkers with HF severity and comorbidities, the causal association of certain markers and pathways with specific types or aspects of HF remains to be elucidated. When used as treatment response markers in conjunction with other risk factors, inflammatory markers have the potential to improve risk stratification of patients with HF and personalize HF treatment, with the ultimate goal to improve quality of life and prolong survival in these patients.
急性心脏疾病治疗效果的改善、人口老龄化、普遍存在的与生活方式相关的风险因素以及心力衰竭（HF）治疗的进展，所有这些都导致HF的患病率不断上升，目前HF在发达国家被视为公共卫生重点，在发展中地区则是一种主要的非传染性综合征。心力衰竭是一种复杂的综合征，有许多病理生理机制在起作用。炎症是体内平衡的一个组成部分，是机体对压力源的一种复杂组织反应，旨在减轻其影响并启动愈合过程。炎症在HF的发生、发展过程、严重程度及预后中起着关键作用。促炎和抗炎过程的微妙平衡可能对衰竭心脏产生有益或有害的影响。在本文中，我们综述了关于炎症生物标志物及其在HF患者预后和治疗决策中潜在作用的证据。尽管由于缺乏疗效和潜在危害，直接干扰HF炎症级联反应的尝试大多已被放弃，但我们的知识仍存在重要空白。尽管炎症生物标志物水平与HF严重程度和合并症密切相关，但某些标志物和途径与HF特定类型或方面的因果关系仍有待阐明。当与其他风险因素一起用作治疗反应标志物时，炎症标志物有可能改善HF患者的风险分层并实现HF治疗的个性化，最终目标是改善这些患者的生活质量并延长生存期。
