Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester, M1 5GD, UK.
Intensive Care Unit, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, Warrington Road, Prescot, L35 5DR, UK.
Mikrochim Acta. 2022 Mar 12;189(4):142. doi: 10.1007/s00604-022-05186-9.
Determination of specific cardiac biomarkers (CBs) during the diagnosis and management of adverse cardiovascular events such as acute myocardial infarction (AMI) has become commonplace in emergency department (ED), cardiology and many other ward settings. Cardiac troponins (cTnT and cTnI) and natriuretic peptides (BNP and NT-pro-BNP) are the preferred biomarkers in clinical practice for the diagnostic workup of AMI, acute coronary syndrome (ACS) and other types of myocardial ischaemia and heart failure (HF), while the roles and possible clinical applications of several other potential biomarkers continue to be evaluated and are the subject of several comprehensive reviews. The requirement for rapid, repeated testing of a small number of CBs in ED and cardiology patients has led to the development of point-of-care (PoC) technology to circumvent the need for remote and lengthy testing procedures in the hospital pathology laboratories. Electroanalytical sensing platforms have the potential to meet these requirements. This review aims firstly to reflect on the potential benefits of rapid CB testing in critically ill patients, a very distinct cohort of patients with deranged baseline levels of CBs. We summarise their source and clinical relevance and are the first to report the required analytical ranges for such technology to be of value in this patient cohort. Secondly, we review the current electrochemical approaches, including its sub-variants such as photoelectrochemical and electrochemiluminescence, for the determination of important CBs highlighting the various strategies used, namely the use of micro- and nanomaterials, to maximise the sensitivities and selectivities of such approaches. Finally, we consider the challenges that must be overcome to allow for the commercialisation of this technology and transition into intensive care medicine.
在急诊科、心脏病学和许多其他病房环境中，确定特定的心脏生物标志物（CBs）在急性心血管事件（如急性心肌梗死 [AMI]）的诊断和管理中已变得司空见惯。心肌钙蛋白（cTnT 和 cTnI）和利钠肽（BNP 和 NT-pro-BNP）是临床实践中用于诊断 AMI、急性冠状动脉综合征（ACS）和其他类型心肌缺血和心力衰竭（HF）的首选生物标志物，而其他几种潜在生物标志物的作用和可能的临床应用仍在评估中，也是几篇综合评论的主题。在急诊科和心脏病学患者中需要快速、重复检测少数 CBs，这导致了即时护理（PoC）技术的发展，以避免在医院病理实验室进行远程和冗长的测试程序。电化学生感平台有可能满足这些要求。本综述首先旨在反思快速 CB 测试在危重病患者中的潜在益处，这些患者是一组具有明显 CB 基础水平紊乱的非常独特的患者群体。我们总结了它们的来源和临床相关性，并首次报告了此类技术在该患者群体中具有价值所需的分析范围。其次，我们回顾了当前的电化学方法，包括光电化学和电化学发光等亚变体，用于测定重要的 CBs，重点介绍了用于最大化此类方法的灵敏度和选择性的各种策略，即使用微纳米材料。最后，我们考虑了必须克服的挑战，以使这项技术能够商业化并过渡到重症监护医学。
