Viduljević Mihajlo, Polovina Marija, Geavlete Oliviana, Adamo Marianna, Hadžibegović Adi, Ašanin Milika, Stanković Sanja, Ben Gal Tuvia, Abdelwahab Mohamed A, Abdelhamid Magdy, Ambrosy Andrew P, Chioncel Ovidiu, Seferović Petar M
Emergency Medicine and Center for Medical Biochemistry, Department of Cardiology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Int J Mol Sci. 2025 Sep 17;26(18):9064. doi: 10.3390/ijms26189064.
Right ventricular (RV) dysfunction is common and linked to poor outcomes across conditions such as heart failure (HF), acute coronary syndromes, pulmonary embolism, and pulmonary hypertension. While imaging, electrocardiogram (ECG), and invasive tests remain central to RV assessment, circulating biomarkers offer a rapid, non-invasive, and reliable alternative. These biomarkers reflect key pathophysiological processes, including myocardial injury, stress, fibrosis, inflammation, congestion, and multiorgan involvement. High-sensitivity troponins and natriuretic peptides (BNP, NT-proBNP) are already widely used, while emerging biomarkers-such as CA125, copeptin, galectin-3, and others-may enhance diagnostic accuracy and risk stratification. Some, like CA125 and NT-proBNP, have shown promise in guiding post-discharge therapy. However, challenges remain regarding the specificity of biomarkers for RV dysfunction and their role across different clinical contexts. This review provides an integrated overview of RV dysfunction, with a focus on the diagnostic and therapeutic potential of both established and novel biomarkers.
右心室（RV）功能障碍很常见，并且与心力衰竭（HF）、急性冠脉综合征、肺栓塞和肺动脉高压等多种病症的不良预后相关。虽然影像学、心电图（ECG）和侵入性检查仍是评估右心室的核心手段，但循环生物标志物提供了一种快速、非侵入性且可靠的替代方法。这些生物标志物反映了关键的病理生理过程，包括心肌损伤、应激、纤维化、炎症、充血和多器官受累。高敏肌钙蛋白和利钠肽（BNP、NT-proBNP）已被广泛应用，而诸如CA125、 copeptin、半乳糖凝集素-3等新兴生物标志物可能会提高诊断准确性和风险分层。一些生物标志物，如CA125和NT-proBNP，在指导出院后治疗方面已显示出前景。然而，生物标志物对右心室功能障碍的特异性及其在不同临床背景下的作用仍存在挑战。本综述对右心室功能障碍进行了综合概述，重点关注已确立的和新型生物标志物的诊断及治疗潜力。
