利用心脏成像与生物标志物的心力衰竭诊断和预后评估的多维方法。
Multidimensional Approach of Heart Failure Diagnosis and Prognostication Utilizing Cardiac Imaging with Biomarkers.
作者信息
Kim In-Cheol, Yoo Byung-Su
机构信息
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Hospital, Keimyung University College of Medicine, Daegu 42601, Korea.
Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea.
出版信息
Diagnostics (Basel). 2022 Jun 1;12(6):1366. doi: 10.3390/diagnostics12061366.
Heart failure (HF) is a clinical syndrome caused by various etiologies that results in systolic and diastolic cardiac dysfunction with congestion. While evaluating HF and planning for treatment, physicians utilize various laboratory tests, including electrocardiography, diverse imaging tests, exercise testing, invasive hemodynamic evaluation, or endomyocardial biopsy. Among these, cardiac imaging modalities and biomarkers are the mainstays during HF diagnosis and treatment. Recent developments in non-invasive imaging modalities, such as echocardiography, computed tomography, magnetic resonance imaging, and nuclear imaging, have helped us understand the etiology, pathophysiology, and hemodynamics of HF, and determine treatment options and predict the outcomes. Due to the convenience of their use and potential impact on HF management, biomarkers are increasingly adopted in our clinical practice as well as research purpose. Natriuretic peptide is the most widely used biomarker for the diagnosis of HF, evaluation of treatment response, and prediction of future outcomes. Other cardiac biomarkers to evaluate the pathophysiological mechanisms of HF include myocardial injury, oxidative stress, inflammation, fibrosis, hypertrophy, and neurohormonal activation. Because HF results from complex cardiac disorders, it is essential to assess the disease status multidimensionally. The proper utilization of multimodality imaging and cardiac biomarkers can improve the quality of patient management and predict clinical outcomes in HF in the era of personalized medicine.
心力衰竭(HF)是一种由多种病因引起的临床综合征,可导致心脏收缩和舒张功能障碍并伴有充血。在评估心力衰竭并制定治疗方案时,医生会使用各种实验室检查,包括心电图、多种影像学检查、运动试验、有创血流动力学评估或心内膜心肌活检。其中,心脏成像方式和生物标志物是心力衰竭诊断和治疗的主要手段。超声心动图、计算机断层扫描、磁共振成像和核成像等无创成像方式的最新进展,有助于我们了解心力衰竭的病因、病理生理学和血流动力学,确定治疗方案并预测预后。由于其使用方便且对心力衰竭管理有潜在影响,生物标志物在我们的临床实践以及研究中越来越多地被采用。利钠肽是用于诊断心力衰竭、评估治疗反应和预测未来预后的最广泛使用的生物标志物。其他用于评估心力衰竭病理生理机制的心脏生物标志物包括心肌损伤、氧化应激、炎症、纤维化、肥大和神经激素激活。由于心力衰竭是由复杂的心脏疾病引起的,因此多维评估疾病状态至关重要。在个性化医疗时代,正确使用多模态成像和心脏生物标志物可以提高患者管理质量并预测心力衰竭的临床结局。
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