Badianyama Marheb, Mpanya Dineo, Adamu Umar, Sigauke Farai, Nel Samantha, Tsabedze Nqoba
Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa.
J Cardiovasc Dev Dis. 2022 Oct 2;9(10):335. doi: 10.3390/jcdd9100335.
Heart failure is a clinical syndrome resulting from various cardiovascular diseases of different aetiologies and pathophysiology. These varying pathologies involve several complex mechanisms that lead to the activation of the neurohumoral system, inflammation, angiogenesis, apoptosis, fibrosis, and eventually adverse cardiac remodelling associated with a progressive decline in cardiac function. Once a diagnosis is made, the cardiac function has a gradual decline characterised by multiple hospital admissions. It is therefore imperative to identify patients at different stages of the heart failure continuum to better risk stratify and initiate optimal management strategies. Biomarkers may play a role in the diagnosis, prognostication, and monitoring response to treatment. This review discusses the epidemiology of heart failure and biomarkers commonly used in clinical practice such as natriuretic peptides and cardiac troponins. In addition, we provide a brief overview of novel biomarkers and genetic coding and non-coding biomarkers used in the management of patients with heart failure. We also discuss barriers that hinder the clinical application of novel biomarkers. Finally, we appraise the value of polygenic risk scoring, focusing on sub-Saharan Africa.
心力衰竭是一种由不同病因和病理生理学的各种心血管疾病引起的临床综合征。这些不同的病理涉及多种复杂机制，导致神经体液系统激活、炎症、血管生成、细胞凋亡、纤维化，并最终导致与心功能进行性下降相关的不良心脏重塑。一旦确诊，心功能会逐渐下降，其特征是多次住院。因此，识别心力衰竭连续体不同阶段的患者，以更好地进行风险分层并启动最佳管理策略至关重要。生物标志物可能在诊断、预后评估和治疗反应监测中发挥作用。本综述讨论了心力衰竭的流行病学以及临床实践中常用的生物标志物，如利钠肽和心肌肌钙蛋白。此外，我们简要概述了用于心力衰竭患者管理的新型生物标志物以及基因编码和非编码生物标志物。我们还讨论了阻碍新型生物标志物临床应用的障碍。最后，我们评估多基因风险评分的价值，重点关注撒哈拉以南非洲地区。
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