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心力衰竭早期检测中的新型生物标志物:一篇叙述性综述。

Novel Biomarkers in Early Detection of Heart Failure: A Narrative Review.

作者信息

Kayani Maryam, Fatima Neha, Yarra Pooja Chowdary, Almansouri Naiela E, K Deepshikha, Balasubramanian Abirami, Parvathaneni Navya, Mowo-Wale Adetola G, Valdez Josue A, Nazir Zahra

机构信息

Cardiology, Shifa Tameer-e-Millat University Shifa College of Medicine, Islamabad, PAK.

Internal Medicine, Lisie Hospital, Kochi, IND.

出版信息

Cureus. 2024 Feb 2;16(2):e53445. doi: 10.7759/cureus.53445. eCollection 2024 Feb.

Abstract

Heart failure (HF) represents a significant global health challenge, characterized by a variety of symptoms resulting from cardiac dysfunction. This dysfunction often leads to systemic and pulmonary congestion. The pathophysiology of HF is complex, involving stimulation of the sympathetic nervous system, which is insufficiently balanced by the release of natriuretic peptide. This imbalance leads to progressive hypertrophy and dilatation of the heart's chambers, impairing its pumping efficiency and increasing the risk of arrhythmias and conduction disorders. The prevalence of HF is exceptionally high in industrialized nations and is expected to increase owing to an aging population and advancements in diagnostic methods. This study emphasizes the critical role of early diagnosis in reducing morbidity and mortality associated with HF, focusing specifically on the evolving importance of biomarkers in managing this condition. Biomarkers have played a key role in transforming the diagnosis and treatment of HF. Traditional biomarkers such as b-type natriuretic peptide and N-terminal pro-b-type natriuretic peptide have been widely adopted for their cost-effectiveness and ease of access. However, the rise of novel biomarkers such as growth differentiation factor 15 and adrenomedullin has shown promising results, offering superior sensitivity and specificity. These new biomarkers enhance diagnostic accuracy, risk stratification, and prognostic evaluation in HF patients. Despite these advancements, challenges remain, such as limited availability, high costs, and the need for further validation in diverse patient populations. Through a comprehensive literature review across databases such as PubMed, Google Scholar, and the Cochrane Library, this study compiles and analyzes data from 18 relevant studies, offering a detailed understanding of the current state of HF biomarkers. The study examines both traditional and emerging biomarkers such as galectin-3 and soluble suppression of tumorigenicity 2 in HF, exploring their clinical roles and impact on patient outcomes.

摘要

心力衰竭(HF)是一项重大的全球健康挑战,其特征是心脏功能障碍导致的各种症状。这种功能障碍通常会导致全身和肺部充血。HF的病理生理学很复杂,涉及交感神经系统的刺激,而利钠肽的释放未能充分平衡这种刺激。这种失衡会导致心脏腔室逐渐肥大和扩张,损害其泵血效率,并增加心律失常和传导障碍的风险。HF在工业化国家的患病率极高,并且由于人口老龄化和诊断方法的进步,预计患病率还会上升。本研究强调早期诊断在降低与HF相关的发病率和死亡率方面的关键作用,特别关注生物标志物在管理这种疾病中不断演变的重要性。生物标志物在HF的诊断和治疗转变中发挥了关键作用。传统生物标志物如b型利钠肽和N末端前体b型利钠肽因其成本效益高和易于获取而被广泛采用。然而,生长分化因子15和肾上腺髓质素等新型生物标志物的出现已显示出有前景的结果,具有更高的敏感性和特异性。这些新的生物标志物提高了HF患者的诊断准确性、风险分层和预后评估。尽管取得了这些进展,但挑战依然存在,如可用性有限、成本高昂以及需要在不同患者群体中进一步验证。通过对PubMed、谷歌学术和考克兰图书馆等数据库进行全面的文献综述,本研究汇编并分析了18项相关研究的数据,对HF生物标志物的当前状况进行了详细了解。该研究考察了HF中的传统和新兴生物标志物,如半乳糖凝集素-3和可溶性肿瘤抑制因子2,探讨了它们的临床作用及其对患者预后的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2468/10909379/41ed109d9569/cureus-0016-00000053445-i01.jpg

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