Internal Medicine Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700503 Iași, Romania.
Cardiology Department, Cardiovascular Diseases Institute "Prof. Dr. George I. M. Georgescu", 700503 Iași, Romania.
Int J Mol Sci. 2021 May 26;22(11):5688. doi: 10.3390/ijms22115688.
Non-ischemic dilated cardiomyopathy encompasses a wide spectrum of myocardial disorders, characterized by left ventricular dilatation with systolic impairment and increased risk of sudden cardiac death. In spite of all the therapeutic progress that has been made in recent years, dilated cardiomyopathy continues to be an important cause of cardiac transplant, being associated with an enormous cost burden for health care systems worldwide. Predicting the prognosis of patients with dilated cardiomyopathy is essential to individualize treatment. Late gadolinium enhancement-cardiac magnetic resonance imaging, microvolt T-wave alternans, and genetic testing have emerged as powerful tools in predicting sudden cardiac death occurrence and maximizing patient's selection. Despite all these new diagnostic modalities, additional tests to complement or replace current tools are required for better risk stratification. Therefore, biomarkers are an easy and important tool that can help to detect patients at risk of adverse cardiovascular events. Additionally, identifying potential biomarkers involved in dilated cardiomyopathy can provide us important information regarding the diagnostic, prognostic, risk stratification, and response to treatment for these patients. Many potential biomarkers have been studied in patients with dilated cardiomyopathy, but only a few have been adopted in current practice. Therefore, the aim of our review is to provide the clinicians with an update on the well-known and novel biomarkers that can be useful for risk stratification of patients with non-ischemic dilated cardiomyopathy.
非缺血性扩张型心肌病涵盖了广泛的心肌疾病谱,其特征为左心室扩张伴收缩功能障碍,并增加了心源性猝死的风险。尽管近年来在治疗方面取得了所有进展,但扩张型心肌病仍然是心脏移植的重要原因,给全球医疗保健系统带来了巨大的经济负担。预测扩张型心肌病患者的预后对于个体化治疗至关重要。钆延迟增强心脏磁共振成像、微伏 T 波交替和基因检测已成为预测心源性猝死发生和最大程度选择患者的有力工具。尽管有了所有这些新的诊断方法,但仍需要额外的测试来补充或替代当前的工具,以更好地进行风险分层。因此,生物标志物是一种简单而重要的工具,可以帮助检测有不良心血管事件风险的患者。此外,确定扩张型心肌病中涉及的潜在生物标志物可以为我们提供有关这些患者的诊断、预后、风险分层和治疗反应的重要信息。已经在扩张型心肌病患者中研究了许多潜在的生物标志物,但只有少数几个已被纳入当前的临床实践。因此,我们的综述旨在为临床医生提供有关可用于非缺血性扩张型心肌病患者风险分层的知名和新型生物标志物的最新信息。