Simonavičius Justas, Mikalauskas Aurimas, Brunner-La Rocca Hans-Peter
Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Santariskiu Str. 2, LT-08406, Vilnius, Lithuania.
Heart Fail Rev. 2021 May;26(3):731-732. doi: 10.1007/s10741-020-09950-y.
In spite of high prevalence, congestion remains a poorly understood phenomenon in heart failure pathophysiology. Its negative impact on outcome has been widely recognised. Still, data from various registries reveal the failure of the contemporary treatment strategies to overcome congestion. This shortcoming is closely related to the fact that there are no universe means for congestion assessment and grading, making it a difficult process to recognise. CD146 is a novel blood biomarker of congestion that has been shown to reflect intravascular fluid accumulation in a number of experimental and clinical studies. This observation deserves special attention, given the huge gap of knowledge about decongestive strategies in acute and chronic heart failure. Randomised clinical trials testing the effect of CD146-guided management intervention are urgently needed to estimate its value in heart failure care.
尽管充血在心力衰竭病理生理学中普遍存在，但其仍是一种了解甚少的现象。其对预后的负面影响已得到广泛认可。然而，来自各种登记处的数据显示，当代治疗策略未能克服充血问题。这一缺点与缺乏统一的充血评估和分级方法密切相关，使得充血难以识别。CD146是一种新型的充血血液生物标志物，在多项实验和临床研究中已显示其可反映血管内液体蓄积。鉴于急性和慢性心力衰竭中关于消肿策略的知识存在巨大差距，这一观察结果值得特别关注。迫切需要进行随机临床试验来测试CD146指导的管理干预措施的效果，以评估其在心力衰竭治疗中的价值。
