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经典和新型生物标志物作为室性心律失常和心源性猝死的潜在预测指标

Classic and Novel Biomarkers as Potential Predictors of Ventricular Arrhythmias and Sudden Cardiac Death.

作者信息

Shomanova Zornitsa, Ohnewein Bernhard, Schernthaner Christiane, Höfer Killian, Pogoda Christian A, Frommeyer Gerrit, Wernly Bernhard, Brandt Mathias C, Dieplinger Anna-Maria, Reinecke Holger, Hoppe Uta C, Strohmer Bernhard, Pistulli Rudin, Motloch Lukas J

机构信息

Department of Cardiology I, Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Albert Schweitzer Campus 1, A1, 48149 Muenster, Germany.

Clinic II for Internal Medicine, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria.

出版信息

J Clin Med. 2020 Feb 20;9(2):578. doi: 10.3390/jcm9020578.

Abstract

Sudden cardiac death (SCD), most often induced by ventricular arrhythmias, is one of the main reasons for cardiovascular-related mortality. While coronary artery disease remains the leading cause of SCD, other pathologies like cardiomyopathies and, especially in the younger population, genetic disorders, are linked to arrhythmia-related mortality. Despite many efforts to enhance the efficiency of risk-stratification strategies, effective tools for risk assessment are still missing. Biomarkers have a major impact on clinical practice in various cardiac pathologies. While classic biomarkers like brain natriuretic peptide (BNP) and troponins are integrated into daily clinical practice, inflammatory biomarkers may also be helpful for risk assessment. Indeed, several trials investigated their application for the prediction of arrhythmic events indicating promising results. Furthermore, in recent years, active research efforts have brought forward an increasingly large number of "novel and alternative" candidate markers of various pathophysiological origins. Investigations of these promising biological compounds have revealed encouraging results when evaluating the prediction of arrhythmic events. To elucidate this issue, we review current literature dealing with this topic. We highlight the potential of "classic" but also "novel" biomarkers as promising tools for arrhythmia prediction, which in the future might be integrated into clinical practice.

摘要

心脏性猝死(SCD)通常由室性心律失常诱发,是心血管相关死亡的主要原因之一。虽然冠状动脉疾病仍然是SCD的主要原因,但其他病理状况,如心肌病,尤其是在年轻人群中,遗传疾病,也与心律失常相关的死亡有关。尽管人们为提高风险分层策略的效率做出了许多努力,但仍然缺乏有效的风险评估工具。生物标志物在各种心脏疾病的临床实践中具有重大影响。虽然像脑钠肽(BNP)和肌钙蛋白等经典生物标志物已融入日常临床实践,但炎症生物标志物可能也有助于风险评估。事实上,多项试验研究了它们在预测心律失常事件中的应用,结果显示很有前景。此外,近年来,积极的研究工作提出了越来越多源自各种病理生理机制的“新型和替代性”候选标志物。在评估这些有前景的生物化合物对心律失常事件的预测时,研究结果令人鼓舞。为阐明这一问题,我们回顾了当前关于该主题的文献。我们强调“经典”以及“新型”生物标志物作为心律失常预测的有前景工具的潜力,未来它们可能会被纳入临床实践。

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