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心脏生物标志物及其在识别 COVID-19 患者心血管并发症风险增加中的作用。

Cardiac Biomarkers and Their Role in Identifying Increased Risk of Cardiovascular Complications in COVID-19 Patients.

作者信息

Yaluri Nagendra, Stančáková Yaluri Alena, Žeňuch Pavol, Žeňuchová Zuzana, Tóth Štefan, Kalanin Peter

机构信息

Center of Clinical and Preclinical Research, University Research Park Medipark, P. J. Šafárik University, 040 01 Košice, Slovakia.

4th Department of Internal Medicine, P. J. Šafárik University, 040 01 Košice, Slovakia.

出版信息

Diagnostics (Basel). 2023 Jul 27;13(15):2508. doi: 10.3390/diagnostics13152508.

Abstract

Cardiovascular disease (CVD) is a global health concern, causing significant morbidity and mortality. Both lifestyle and genetics influence the development of CVD. It is often diagnosed late, when the treatment options are limited. Early diagnosis of CVD with help of biomarkers is necessary to prevent adverse outcomes. SARS-CoV-2 infection can cause cardiovascular complications even in patients with no prior history of CVD. This review highlights cardiovascular biomarkers, including novel ones, and their applications as diagnostic and prognostic markers of cardiovascular complications related to SARS-CoV-2 infection. Patients with severe SARS-CoV-2 infection were shown to have elevated levels of cardiac biomarkers, namely N-terminal pro-brain natriuretic peptide (NT-pro-BNP), creatine kinase-myocardial band (CK-MB), and troponins, indicating acute myocardial damage. These biomarkers were also associated with higher mortality rates and therefore should be used throughout COVID-19 patient care to identify high-risk patients promptly to optimize their outcomes. Additionally, microRNAs (miRNAs) are also considered as potential biomarkers and predictors of cardiac and vascular damage in SARS-CoV-2 infection. Identifying molecular pathways contributing to cardiovascular manifestations in COVID-19 is essential for development of early biomarkers, identification of new therapeutic targets, and better prediction and management of cardiovascular outcomes.

摘要

心血管疾病(CVD)是一个全球性的健康问题,会导致严重的发病和死亡。生活方式和遗传因素都会影响心血管疾病的发展。它往往在治疗选择有限时才被晚期诊断出来。借助生物标志物对心血管疾病进行早期诊断对于预防不良后果至关重要。即使在没有心血管疾病既往史的患者中,新型冠状病毒2(SARS-CoV-2)感染也可导致心血管并发症。本综述重点介绍了心血管生物标志物,包括新型生物标志物,及其作为与SARS-CoV-2感染相关的心血管并发症的诊断和预后标志物的应用。研究表明,患有严重SARS-CoV-2感染的患者心脏生物标志物水平升高,即N端前脑钠肽(NT-pro-BNP)、肌酸激酶心肌型同工酶(CK-MB)和肌钙蛋白,这表明存在急性心肌损伤。这些生物标志物还与较高的死亡率相关,因此在整个新冠肺炎患者护理过程中都应使用它们,以便及时识别高危患者,优化其治疗结果。此外,微小RNA(miRNA)也被认为是SARS-CoV-2感染中心脏和血管损伤的潜在生物标志物和预测指标。确定导致新冠肺炎心血管表现的分子途径对于开发早期生物标志物、识别新的治疗靶点以及更好地预测和管理心血管疾病结局至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/501f/10417576/a8206d720a26/diagnostics-13-02508-g001.jpg

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