School of Biotechnology, Dublin City University, 9 Dublin, Ireland.
Research Complex, Hamad Bin Khalifa University, Qatar Foundation, P.O. Box 34110 Doha, Qatar.
Biosensors (Basel). 2018 Nov 21;8(4):114. doi: 10.3390/bios8040114.
Cardiac biomarkers are frequently measured to provide guidance on the well-being of a patient in relation to cardiac health with many assays having been developed and widely utilised in clinical assessment. Effectively treating and managing cardiovascular disease (CVD) relies on swiftly responding to signs of cardiac symptoms, thus providing a basis for enhanced patient management and an overall better health outcome. Ultra-sensitive cardiac biomarker detection techniques play a pivotal role in improving the diagnostic capacity of an assay and thus enabling a better-informed decision. However, currently, the typical approach taken within healthcare depends on centralised laboratories performing analysis of cardiac biomarkers, thus restricting the roll-out of rapid diagnostics. Point-of-care testing (POCT) involves conducting the diagnostic test in the presence of the patient, with a short turnaround time, requiring small sample volumes without compromising the sensitivity of the assay. This technology is ideal for combatting CVD, thus the formulation of ultra-sensitive assays and the design of biosensors will be critically evaluated, focusing on the feasibility of these techniques for point-of-care (POC) integration. Moreover, there are several key factors, which in combination, contribute to the development of ultra-sensitive techniques, namely the incorporation of nanomaterials for sensitivity enhancement and manipulation of labelling methods. This review will explore the latest developments in cardiac biomarker detection, primarily focusing on the detection of cardiac troponin I (cTnI). Highly sensitive detection of cTnI is of paramount importance regarding the rapid rule-in/rule-out of acute myocardial infarction (AMI). Thus the challenges encountered during cTnI measurements are outlined in detail to assist in demonstrating the drawbacks of current commercial assays and the obstructions to standardisation. Furthermore, the added benefits of introducing multi-biomarker panels are reviewed, several key biomarkers are evaluated and the analytical benefits provided by multimarkers-based methods are highlighted.
心脏生物标志物常用于评估患者的心脏健康状况，目前已经开发出许多检测方法并广泛应用于临床评估。有效治疗和管理心血管疾病（CVD）依赖于迅速对心脏症状做出反应，为患者管理提供依据，从而改善整体健康结果。超敏心脏生物标志物检测技术在提高检测能力方面发挥着关键作用，从而为更明智的决策提供依据。然而，目前医疗保健领域通常依赖于中心实验室进行心脏生物标志物分析，从而限制了快速诊断的应用。即时检测（POCT）涉及在患者在场的情况下进行诊断测试，具有较短的周转时间，需要小样本量，而不会影响检测的灵敏度。该技术非常适合治疗 CVD，因此将对超敏检测方法的制定和生物传感器的设计进行严格评估，重点关注这些技术在即时检测（POC）集成方面的可行性。此外，有几个关键因素共同促成了超敏技术的发展，包括用于提高灵敏度的纳米材料的整合以及标记方法的改进。本综述将探讨心脏生物标志物检测的最新进展，主要关注心脏肌钙蛋白 I（cTnI）的检测。cTnI 的高度敏感检测对于急性心肌梗死（AMI）的快速排除/确诊至关重要。因此，详细阐述了 cTnI 测量中遇到的挑战，以帮助说明当前商业检测方法的缺点以及标准化的障碍。此外，还综述了引入多生物标志物检测的额外优势，评估了几个关键的生物标志物，并强调了基于多标志物的方法在分析方面的优势。
