Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck, Hamburg, Germany.
J Intern Med. 2018 Jun;283(6):530-543. doi: 10.1111/joim.12756. Epub 2018 Apr 22.
Heart failure (HF) is a rising epidemic due to the ageing population and progress in all areas of medicine. Thus, research efforts are made to ensure a timely diagnosis, to improve prognosis and treatment of the disease and to facilitate risk prediction at the population level. Because of their noninvasive determination with mostly high sensitivity and accuracy, circulating blood biomarkers are becoming increasingly important for daily clinical practice. Natriuretic peptides, especially B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and midregional pro-atrial natriuretic peptide (MR-proANP) and cardiac troponins are established blood biomarkers in HF diagnosis and prognosis of HF-related outcomes. Inflammatory molecules as C-reactive protein (CRP) may have added value in anti-inflammatory therapy guidance. Next-generation biomarkers including soluble source of tumorigenicity 2 (sST2), growth differentiation factor-15 (GDF-15), galectin-3 (Gal-3) and diverse microribonucleic acids (miRNAs) may have additional benefit in assessment of cardiac remodeling or differentiation of HF subtypes. Multimarker approaches containing different combinations of established and novel biomarkers might improve HF risk prediction at the population level once they are used on top of clinical variables.
心力衰竭（HF）是一种由于人口老龄化和医学各领域进步而不断上升的流行疾病。因此，人们正在努力研究以确保及时诊断，改善疾病的预后和治疗，并促进人群水平的风险预测。由于它们具有非侵入性的特点，且通常具有较高的灵敏度和准确性，因此循环血液生物标志物在日常临床实践中变得越来越重要。利钠肽，尤其是 B 型利钠肽（BNP）、氨基末端 B 型利钠肽前体（Nt-proBNP）和中段 pro 心房利钠肽（MR-proANP）以及心肌肌钙蛋白是 HF 诊断和 HF 相关结局预后的既定血液生物标志物。炎症分子如 C 反应蛋白（CRP）在抗炎治疗指导方面可能具有附加价值。包括可溶性肿瘤源 2（sST2）、生长分化因子 15（GDF-15）、半乳糖凝集素 3（Gal-3）和多种微小 RNA（miRNAs）在内的下一代生物标志物在心功能重构评估或 HF 亚型区分方面可能具有额外的益处。包含既定和新型生物标志物不同组合的多标志物方法可能会提高人群水平的 HF 风险预测，一旦它们在临床变量的基础上使用。
