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生物标志物在心脏淀粉样变性的早期诊断和预后中的作用:系统评价和荟萃分析。

Role of biomarkers in early diagnosis and prognosis of cardiac amyloidosis: A systematic review and meta-analysis.

机构信息

Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman.

Heart Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.

出版信息

Curr Probl Cardiol. 2025 Jan;50(1):102883. doi: 10.1016/j.cpcardiol.2024.102883. Epub 2024 Oct 28.

Abstract

BACKGROUND

Cardiac amyloidosis is characterized by amyloid fibril deposition in the heart, leading to restrictive cardiomyopathy and heart failure. Early diagnosis and monitoring are crucial for effective management. This systematic review and meta-analysis evaluates the utility of various biomarkers in the early detection, disease progression, and prognosis of cardiac amyloidosis.

METHODS

We conducted a comprehensive search of PubMed, Scopus, and Web of Science databases for studies published between 2000 and 2024 that assessed the diagnostic and prognostic value of biomarkers in cardiac amyloidosis. Data were extracted and analyzed to determine the sensitivity, specificity, and prognostic significance of each biomarker. The correlation between biomarker levels and imaging findings was also explored.

RESULTS

A total of 45 studies were included in the meta-analysis. NT-proBNP and troponins had high sensitivity and specificity for early diagnosis of cardiac amyloidosis. Novel biomarkers, such as serum amyloid P component and light-chain assays, showed promise in distinguishing between amyloidosis subtypes and predicting disease progression. However, significant variability existed in the correlation between biomarkers and imaging findings.

CONCLUSIONS

Biomarkers are crucial for early diagnosis and prognosis of cardiac amyloidosis. NT-proBNP and troponins are well-established markers, while novel biomarkers offer additional insights into disease progression and subtype differentiation.

摘要

背景

心脏淀粉样变性的特征是心脏中淀粉样纤维沉积,导致限制型心肌病和心力衰竭。早期诊断和监测对于有效管理至关重要。本系统评价和荟萃分析评估了各种生物标志物在心脏淀粉样变性的早期检测、疾病进展和预后中的作用。

方法

我们对 2000 年至 2024 年期间发表的评估生物标志物在心脏淀粉样变性中的诊断和预后价值的研究进行了全面的 PubMed、Scopus 和 Web of Science 数据库检索。提取和分析数据以确定每种生物标志物的敏感性、特异性和预后意义。还探讨了生物标志物水平与影像学发现之间的相关性。

结果

荟萃分析共纳入 45 项研究。NT-proBNP 和肌钙蛋白对心脏淀粉样变性的早期诊断具有较高的敏感性和特异性。新型生物标志物,如血清淀粉样蛋白 P 成分和轻链检测,在区分淀粉样变性亚型和预测疾病进展方面显示出希望。然而,生物标志物与影像学发现之间的相关性存在显著差异。

结论

生物标志物对于心脏淀粉样变性的早期诊断和预后至关重要。NT-proBNP 和肌钙蛋白是成熟的标志物,而新型生物标志物则提供了对疾病进展和亚型分化的更多见解。

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