[用于心力衰竭诊断和管理的生物标志物:新前沿]
[Biomarkers for the diagnosis and management of heart failure: new frontiers].
作者信息
Vergaro Giuseppe, Castiglione Vincenzo, Aimo Alberto, Prontera Concetta, Musetti Veronica, Masotti Silvia, Giannelli Elena, Maltinti Maristella, Passino Claudio, Emdin Michele
机构信息
Istituto di Scienze della Vita, Scuola Superiore Sant'Anna, Pisa - Fondazione Toscana Gabriele Monasterio, Pisa.
Istituto di Scienze della Vita, Scuola Superiore Sant'Anna, Pisa.
出版信息
G Ital Cardiol (Rome). 2021 May;22(5):386-396. doi: 10.1714/3592.35748.
Heart failure (HF) has a complex pathophysiology including neurohormonal activation, inflammation and oxidative stress that, together with comorbidities, promote progressive myocardial damage and cardiac remodeling. Over the years the study of these pathogenic mechanisms has led to the identification of several analytes potentially useful as biomarkers in HF. High-sensitivity troponins and soluble suppression of tumorigenesis-2 are the most promising biomarkers for risk stratification of HF, with independent value to natriuretic peptides. Other biomarkers currently being evaluated as predictors of adverse outcome in HF are galectin-3, growth differentiation factor 15, mid-regional pro-adrenomedullin as well as makers of renal dysfunction. The use of multi-marker scores as well as the application of genomics, transcriptomics, proteomics and metabolomics could further refine the management of HF.
心力衰竭(HF)具有复杂的病理生理学,包括神经激素激活、炎症和氧化应激,这些因素与合并症一起,促进心肌进行性损伤和心脏重塑。多年来,对这些致病机制的研究已导致鉴定出几种可能作为HF生物标志物的分析物。高敏肌钙蛋白和可溶性肿瘤发生抑制因子2是HF风险分层最有前景的生物标志物,对利钠肽具有独立价值。目前正在评估的其他作为HF不良结局预测指标的生物标志物包括半乳糖凝集素-3、生长分化因子15、中段前肾上腺髓质素以及肾功能不全标志物。使用多标志物评分以及基因组学、转录组学、蛋白质组学和代谢组学的应用可能会进一步优化HF的管理。