Christchurch Heart Institute, Department of Medicine, University of Otago-Christchurch, Christchurch, New Zealand.
Cardiovascular Research Institute, National University of Singapore, Singapore, Singapore.
Heart Fail Rev. 2021 Sep;26(5):1203-1217. doi: 10.1007/s10741-020-09928-w.
Acute decompensated heart failure (ADHF) is associated with a high incidence of acute kidney injury (AKI), an abrupt loss of kidney function associated with a near doubling of mortality at 1 year. In addition to the direct threat acute HF itself poses to kidney function, the beneficial effects of commonly prescribed HF treatments must be weighed against their potentially adverse effects on glomerular perfusion. Consequently, there is an urgent need to identify early markers for AKI in ADHF to facilitate timely implementation of supportive measures to minimize kidney damage and improve outcomes. The recent recognition of the diagnostic potential of circulating microRNAs presents the potential to address this gap if microRNAs specific for AKI can be identified in serial plasma, serum and/or urine samples from well-phenotyped cohorts of ADHF patients, including a proportion with AKI. This review summarizes emerging circulating diagnostic and prognostic microRNA biomarkers (serum, plasma or urine) in HF and AKI.
急性失代偿性心力衰竭 (ADHF) 与急性肾损伤 (AKI) 的发病率较高相关，AKI 是一种肾功能突然丧失的疾病，与 1 年内死亡率几乎翻倍相关。除了急性 HF 本身对肾功能的直接威胁外，还必须权衡常用 HF 治疗方法的有益效果与它们对肾小球灌注的潜在不利影响。因此，迫切需要在 ADHF 中识别 AKI 的早期标志物，以便及时采取支持措施，尽量减少肾脏损伤并改善预后。最近对循环 microRNAs 的诊断潜力的认识，如果能在经过良好表型分析的 ADHF 患者的系列血浆、血清和/或尿液样本中识别出特定于 AKI 的 microRNAs，那么就有可能解决这一差距。本综述总结了 HF 和 AKI 中新兴的循环诊断和预后 microRNA 生物标志物（血清、血浆或尿液）。
