First Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece.
Curr Med Chem. 2019;26(5):864-872. doi: 10.2174/0929867324666170727110241.
Aortic valve stenosis is one of the most common valvular heart disorders and the prevalence will rise as the population ages. Once symptomatic patients with aortic valve stenosis tend to fare worse with high mortality rates. Aortic valve replacement is indicated in these patients and besides the standard surgical replacement, a less invasive approach, transcatheter aortic valve implantation, has gained momentum and has showed promising and solid results in patients with high surgical risk. An important aspect of evaluating patients with aortic valve stenosis is the ability to choose the best possible candidate for the procedure. In addition, predicting the short and long-term clinical outcomes after the valve replacement could offer the treating physicians a better insight and provide information for optimal therapy. Biomarkers are biological parameters that can be objectively measured and evaluated as indicators of normal biological processes and are easily monitored. The aim of this review is to critically assess some of the most widely used biomarkers at present (natriuretic peptides, troponins, C-reactive protein) and provide an insight in novel biomarkers that are currently being investigated (galectin-3, growth differentiation factor-15, microRNAs) for possible diagnostic and prognostic use in aortic valve stenosis and transcatheter aortic valve implantation respectively.
主动脉瓣狭窄是最常见的心脏瓣膜疾病之一，随着人口老龄化，其患病率将会上升。一旦出现症状，主动脉瓣狭窄的患者往往预后较差，死亡率较高。这些患者需要进行主动脉瓣置换术，除了标准的手术置换外，一种微创的方法，经导管主动脉瓣植入术，已经得到了发展，并在高手术风险的患者中取得了令人鼓舞和可靠的结果。评估主动脉瓣狭窄患者的一个重要方面是选择最合适的患者进行手术。此外，预测瓣膜置换术后的短期和长期临床结局可以为治疗医生提供更好的洞察力，并为最佳治疗提供信息。生物标志物是可以客观测量和评估的生物学参数，作为正常生物学过程的指标，并且易于监测。本综述的目的是批判性地评估目前（利钠肽、肌钙蛋白、C 反应蛋白）最广泛使用的一些生物标志物，并深入了解目前正在研究的新型生物标志物（半乳糖凝集素-3、生长分化因子-15、microRNAs），分别用于主动脉瓣狭窄和经导管主动脉瓣植入术的可能诊断和预后。
