Cardiology Department, Centro Hospitalar e universitário de Coimbra - Pólo Hospitais da Universidade de Coimbra, Praceta Prof. Mota Pinto, 300 - 075 Coimbra. Portugal.
Cardiology Department, Hospital do Divino Espírito Santo, Avenida D. Manuel I, Matriz, 9500 - 370 Ponta Delgada. Portugal.
Curr Pharm Des. 2017;23(22):3217-3223. doi: 10.2174/1381612823666170317124125.
Change in the architecture and composition of cardiac extracellular matrix is a key element in adverse cardiac remodeling that occurs during heart failure. Most of the times, the result is the development of fibrosis, which has a huge impact on the pathophysiology and clinical outcomes of heart failure syndromes. Several molecules related to collagen metabolism detectable in the blood have been proposed as biomarkers of myocardial fibrosis. Despite concerns regarding the true ability of these biomarkers to reflect quantitative and qualitative changes in myocardial collagen, a growing body of evidence suggests that they may play a potential role in several aspects of heart failure management.
This review aimed to summarize published data regarding the role of circulating biomarkers of collagen metabolism in the assessment of prognosis in patients with heart failure with reduced or mid-range LVEF ventricular ejection fraction (LVEF < 40% or LVEF 40-49%, respectively). Medline electronic database was searched to identify relevant studies published through October 2016.
Most evidence regarding the prognostic value of collagen biomarkers in HF with reduced or mid-range LVEF lies on data concerning PIIINP and several MMPs and TIMP-1. Several prospective studies found that higher levels of PIIINP, several MMPs and TIMP-1 are associated with higher rates of mortality and/or HF hospital admissions in HF patients with LVEF < 50%.
Circulating collagen biomarkers have been shown to play a role in prognostic stratification in heart failure patients with reduced or mid-range ejection fraction.
心脏细胞外基质的结构和组成的改变是心力衰竭时发生不良心脏重构的关键因素。大多数情况下，其结果是纤维化的发展，这对心力衰竭综合征的病理生理学和临床结果有巨大影响。在血液中检测到的几种与胶原代谢相关的分子已被提议作为心肌纤维化的生物标志物。尽管人们对这些生物标志物真正反映心肌胶原的定量和定性变化的能力存在担忧，但越来越多的证据表明，它们可能在心力衰竭管理的几个方面发挥潜在作用。
本综述旨在总结有关循环胶原代谢生物标志物在评估射血分数降低或中间范围（LVEF<40%或 LVEF 分别为 40-49%）心力衰竭患者预后中的作用的已发表数据。通过 Medline 电子数据库检索，以确定截至 2016 年 10 月发表的相关研究。
关于胶原生物标志物在射血分数降低或中间范围心力衰竭中的预后价值的大多数证据都基于关于 PIIINP 和几种 MMPs 和 TIMP-1 的数据。几项前瞻性研究发现，较高水平的 PIIINP、几种 MMPs 和 TIMP-1 与 LVEF<50%的心力衰竭患者死亡率和/或心力衰竭住院率较高相关。
循环胶原生物标志物已被证明在射血分数降低或中间范围心力衰竭患者的预后分层中发挥作用。
