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[精准医学提升心脏病学中的个性化医疗]

[Precision medicine enhances personalized medicine in cardiology].

作者信息

Hasenfuß G, Schuster A, Bergau L, Toischer K

机构信息

Herzzentrum Göttingen, Klinik für Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Georg-August-Universität, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

Deutsches Zentrum für Herz-Kreislauf-Forschung, Standort Göttingen, Göttingen, Deutschland.

出版信息

Inn Med (Heidelb). 2024 Mar;65(3):239-247. doi: 10.1007/s00108-024-01663-w. Epub 2024 Jan 31.

Abstract

Personalized medicine and precision medicine, frequently used synonymously, shall be clearly differentiated. Accordingly, personalization in cardiac medicine is based on the clinical presentation of a patient, as well as his/her cardiovascular risk factors and comorbidities, electrocardiography, imaging, and biomarkers for myocardial load and ischemia. Personalization is based on large clinical trials with detailed subgroup analyses and is practiced on the basis of guidelines. Further in depth personalization is achieved by precision medicine, which is based on innovative imaging for myocardial structure, coronary morphology, and electrophysiology. From the clinical perspective, genome analyses are relevant for comparatively rare monogenetic cardiovascular diseases. While these as well as transcriptome and metabolome analyses play a significant role in cardiovascular research with great translation potential, they have not yet been broadly introduced in the diagnosis, prevention, and treatment of complex cardiovascular diseases. Furthermore, digital technologies have considerable potential in cardiovascular precision medicine. On the one hand, this is based on the frequency of the diseases with the availability of Big Data and, on the other hand, on the availability of bio-signals and sensors of those signals in cardiovascular diseases.

摘要

常被视为同义词的个性化医疗和精准医疗,应予以明确区分。因此,心脏医学中的个性化是基于患者的临床表现、其心血管危险因素和合并症、心电图、影像学以及心肌负荷和缺血的生物标志物。个性化基于进行了详细亚组分析的大型临床试验,并依据指南实施。精准医疗实现了更深入的个性化,它基于针对心肌结构、冠状动脉形态和电生理学的创新成像技术。从临床角度来看,基因组分析与相对罕见的单基因心血管疾病相关。虽然这些分析以及转录组和代谢组分析在具有巨大转化潜力的心血管研究中发挥着重要作用,但它们尚未广泛应用于复杂心血管疾病的诊断、预防和治疗。此外,数字技术在心血管精准医疗中具有相当大的潜力。一方面,这是基于大数据可得情况下疾病的发生频率,另一方面,是基于心血管疾病中生物信号及其传感器的可得性。

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