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心血管生物标志物:精准诊断与预后的工具

Cardiovascular Biomarkers: Tools for Precision Diagnosis and Prognosis.

作者信息

Netala Vasudeva Reddy, Hou Tianyu, Wang Yanbo, Zhang Zhijun, Teertam Sireesh Kumar

机构信息

School of Chemical Engineering and Technology, North University of China, Taiyuan 030051, China.

Department of Dermatology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA.

出版信息

Int J Mol Sci. 2025 Mar 30;26(7):3218. doi: 10.3390/ijms26073218.

Abstract

The present study provides a detailed review of cardiovascular biomarkers critical for the diagnosis, prognosis, and pathophysiology of cardiovascular diseases, the leading cause of global morbidity and mortality. These biomarkers aid in detecting disease onset, progression, and therapeutic responses, providing insights into molecular mechanisms. Enzyme markers like AST, CK-MB, LDH, CA-III, and HBDH are pivotal for detecting myocardial injury during acute events. Protein markers such as CRP, H-FABP, and MPO shed light on inflammation and oxidative stress. Cardiac Troponins, the gold standard for myocardial infarction diagnosis, exhibit high specificity and sensitivity, while IMA and GPBB indicate ischemia and early myocardial damage. Peptide markers, including BNP and NT-proBNP, are crucial for heart failure diagnosis and management, reflecting ventricular stress and remodeling. Novel peptides like MR-proANP and MR-proADM aid in assessing disease severity. Lipid markers such as lipoprotein-associated phospholipase A2 and oxylipins provide insights into lipid metabolism and atherosclerosis. Inflammatory and stress-related biomarkers, including TNFα, IL-6, GDF-15, and Pentraxin 3, illuminate chronic inflammation in CVDs. Hormonal markers like copeptin and endothelin-1 highlight neurohormonal activation, while emerging markers such as ST2, galectin-3, PAPP-A, and TMAO elucidate fibrosis, remodeling, and metabolic dysregulation. The inclusion of microRNAs and long non-coding RNAs represents a breakthrough in biomarker research, offering sensitive tools for early detection, risk stratification, and therapeutic targeting. This review emphasizes the diagnostic and prognostic utility of these biomarkers, advancing cardiovascular care through personalized medicine.

摘要

本研究详细综述了对心血管疾病的诊断、预后和病理生理学至关重要的心血管生物标志物,心血管疾病是全球发病和死亡的主要原因。这些生物标志物有助于检测疾病的发作、进展和治疗反应,为分子机制提供见解。像谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、碳酸酐酶III(CA-III)和α-羟丁酸脱氢酶(HBDH)等酶标志物对于检测急性事件中的心肌损伤至关重要。像C反应蛋白(CRP)、心脏型脂肪酸结合蛋白(H-FABP)和髓过氧化物酶(MPO)等蛋白质标志物揭示了炎症和氧化应激。心肌肌钙蛋白是心肌梗死诊断的金标准,具有高特异性和敏感性,而缺血修饰白蛋白(IMA)和糖原磷酸化酶同工酶BB(GPBB)则提示缺血和早期心肌损伤。包括脑钠肽(BNP)和N末端脑钠肽前体(NT-proBNP)在内的肽标志物对于心力衰竭的诊断和管理至关重要,反映心室压力和重塑。像中段心房利钠肽前体(MR-proANP)和中段肾上腺髓质素(MR-proADM)等新型肽有助于评估疾病严重程度。像脂蛋白相关磷脂酶A2和氧化脂质等脂质标志物为脂质代谢和动脉粥样硬化提供见解。包括肿瘤坏死因子α(TNFα)、白细胞介素-6(IL-6)、生长分化因子15(GDF-15)和五聚素3等炎症和应激相关生物标志物揭示了心血管疾病中的慢性炎症。像 copeptin 和内皮素-1 等激素标志物突出了神经激素激活,而像 ST2、半乳糖凝集素-3、妊娠相关血浆蛋白A(PAPP-A)和氧化三甲胺(TMAO)等新兴标志物阐明了纤维化、重塑和代谢失调。微小RNA和长链非编码RNA的纳入代表了生物标志物研究的一项突破,为早期检测、风险分层和治疗靶点提供了灵敏工具。本综述强调了这些生物标志物的诊断和预后效用,通过个性化医疗推进心血管护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6932/11989402/515788a10ef5/ijms-26-03218-g001.jpg

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