Division of Cardiology, University of California, San Diego, La Jolla, California, USA.
Curr Opin Cardiol. 2019 Mar;34(2):218-224. doi: 10.1097/HCO.0000000000000596.
Biomarkers play a fundamental role in the management of heart failure. Both new and old biomarkers are evaluated every year with new information gained for their use in heart failure. Major advancements have been made in the past 2 years in key biomarkers that will surely become part of standard clinical management of heart failure. This review will focus on major developments since 2016.
Soluble suppression of tumorigenicity 2 has had multiple breakthrough studies solidifying its prognostic use in both acute and chronic heart failure and with multiple studies showing a strong benefit with serial monitoring. High-sensitivity troponin has also recently been demonstrated to be a powerful prognostic biomarker in heart failure. Additionally, it may serve as a novel screening tool to identify patients at high risk for incident heart failure. Natriuretic peptides continue to show their resilience as the main prognostic biomarker in heart failure. Recent studies suggest natriuretic peptides may help identify certain patient populations that benefit from specific therapies and they can predict prognosis beyond in diseases other than heart failure.
Although natriuretic peptides are well-established biomarkers in heart failure, the weight of evidence for soluble suppression of tumorigenicity 2 and high-sensitivity troponin has significantly grown since 2016 that these two biomarkers should be incorporated into regular practice and management of heart failure patients.
生物标志物在心力衰竭的管理中起着至关重要的作用。每年都会评估新的和旧的生物标志物,以获取有关其在心力衰竭中的应用的新信息。在过去的 2 年中,在关键的生物标志物方面取得了重大进展,这些进展肯定将成为心力衰竭标准临床管理的一部分。本篇综述将重点关注自 2016 年以来的主要进展。
可溶性肿瘤抑制物 2 已经有多项突破性研究证实了其在急性和慢性心力衰竭中的预后作用,并且多项研究表明连续监测具有很强的获益。高敏肌钙蛋白最近也被证明是心力衰竭的一种强大的预后生物标志物。此外,它可能作为一种新的筛选工具,用于识别发生心力衰竭风险较高的患者。利钠肽在心力衰竭中仍然是主要的预后生物标志物,其稳定性仍然很好。最近的研究表明,利钠肽可能有助于确定某些患者群体从特定治疗中获益,并且可以预测心力衰竭以外的疾病的预后。
虽然利钠肽是心力衰竭中确立的生物标志物,但自 2016 年以来,可溶性肿瘤抑制物 2 和高敏肌钙蛋白的证据权重显著增加,这两种生物标志物应该被纳入心力衰竭患者的常规实践和管理中。