充血性心力衰竭生物标志物研究进展
Advancements in Biomarkers for Congestive Heart Failure
DOI: 10.12677/jcpm.2025.43325, PDF,   
作者: 孙 娜:济宁医学院临床医学院,山东 济宁;尉希清*:济宁医学院附属医院心内科,山东 济宁
关键词: 充血心力衰竭生物标志物诊断预后Congestion Heart Failure Biomarkers Diagnosis Prognosis
摘要: 心力衰竭是由心肌损伤、心脏前后负荷增大、炎性反应以及神经内分泌系统失调等多种原因导致的心脏结构或功能异常,是许多心血管疾病发展的终末阶段。尽管随着医疗水平的不断进步,心血管疾病的治疗策略得到巨大改进,但心力衰竭在世界范围内的发病率和死亡率仍然居高不下,对其进行早期诊断对治疗及改善预后至关重要。反映心力衰竭发生发展过程的病理生理途径中产生了一系列的循环生物标志物,这些生物标志物可以作为心力衰竭的诊断指标,并为后续治疗和评估预后提供指导依据。此文就心力衰竭生物标志物的研究进展进行综述。
Abstract: Heart failure is a manifestation of cardiac structural or functional abnormalities resulting from various etiologies, including myocardial injury, increased cardiac workload, inflammatory response, and neuroendocrine system disorders. It represents the advanced stage of numerous cardiovascular diseases. Despite significant advancements in treatment strategies for cardiovascular diseases, heart failure continues to exhibit high global morbidity and mortality rates. Therefore, early diagnosis plays a crucial role in guiding treatment interventions and improving prognosis. Pathophysiological pathways give rise to a series of circulating biomarkers that reflect the onset and progression of heart failure. These biomarkers serve as diagnostic indicators for heart failure and offer valuable insights for subsequent treatment decisions and prognostic assessments. This article provides an overview of recent research progress on heart failure biomarkers.
文章引用:孙娜, 尉希清. 充血性心力衰竭生物标志物研究进展[J]. 临床个性化医学, 2025, 4(3): 137-144. https://doi.org/10.12677/jcpm.2025.43325

参考文献

[1] Zhang, Y., Xia, G., Yu, D., Tu, F. and Liu, J. (2024) The Association of Blood Urea Nitrogen to Serum Albumin Ratio with Short-Term Outcomes in Chinese Patients with Congestive Heart Failure: A Retrospective Cohort Study. Nutrition, Metabolism and Cardiovascular Diseases, 34, 55-63. [Google Scholar] [CrossRef] [PubMed]
[2] Mascolo, A., di Mauro, G., Cappetta, D., De Angelis, A., Torella, D., Urbanek, K., et al. (2022) Current and Future Therapeutic Perspective in Chronic Heart Failure. Pharmacological Research, 175, Article ID: 106035. [Google Scholar] [CrossRef] [PubMed]
[3] Sinnenberg, L. and Givertz, M.M. (2020) Acute Heart Failure. Trends in Cardiovascular Medicine, 30, 104-112. [Google Scholar] [CrossRef] [PubMed]
[4] Pandhi, P., ter Maaten, J.M., Anker, S.D., Ng, L.L., Metra, M., Samani, N.J., et al. (2022) Pathophysiologic Processes and Novel Biomarkers Associated with Congestion in Heart Failure. JACC: Heart Failure, 10, 623-632. [Google Scholar] [CrossRef] [PubMed]
[5] Núñez, J., de la Espriella, R., Rossignol, P., et al. (2022) Congestion in Heart Failure: A Circulating Biomarker-Based Perspective. A Review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology. European Journal of Heart Failure, 24,1751-1766.
[6] Townsend, N., Nichols, M., Scarborough, P. and Rayner, M. (2015) Cardiovascular Disease in Europe—Epidemiological Update 2015. European Heart Journal, 36, 2696-2705. [Google Scholar] [CrossRef] [PubMed]
[7] Wang, X., Zhang, F., Zhang, C., Zheng, L. and Yang, J. (2020) The Biomarkers for Acute Myocardial Infarction and Heart Failure. BioMed Research International, 2020, Article ID: 2018035. [Google Scholar] [CrossRef] [PubMed]
[8] Ponikowski, P., Voors, A.A., Anker, S.D., Bueno, H., Cleland, J.G.F., Coats, A.J.S., et al. (2016) 2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure. European Journal of Heart Failure, 18, 891-975. [Google Scholar] [CrossRef] [PubMed]
[9] Schocken, D.D., Benjamin, E.J., Fonarow, G.C., Krumholz, H.M., Levy, D., Mensah, G.A., et al. (2008) Prevention of Heart Failure: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Clinical Cardiology, Cardiovascular Nursing, and High Blood Pressure Research; Quality of Care and Outcomes Research Interdisciplinary Working Group; and Functional Genomics and Translational Biology Interdisciplinary Working Group. Circulation, 117, 2544-2565. [Google Scholar] [CrossRef] [PubMed]
[10] Sawalha, K., Norgard, N.B., Drees, B.M. and López-Candales, A. (2023) Growth Differentiation Factor 15 (GDF-15), a New Biomarker in Heart Failure Management. Current Heart Failure Reports, 20, 287-299. [Google Scholar] [CrossRef] [PubMed]
[11] Castiglione, V., Aimo, A., Vergaro, G., Saccaro, L., Passino, C. and Emdin, M. (2021) Biomarkers for the Diagnosis and Management of Heart Failure. Heart Failure Reviews, 27, 625-643. [Google Scholar] [CrossRef] [PubMed]
[12] Ibrahim, N.E. and Januzzi, J.L. (2018) Established and Emerging Roles of Biomarkers in Heart Failure. Circulation Research, 123, 614-629. [Google Scholar] [CrossRef] [PubMed]
[13] Tsutsui, H., Albert, N.M., Coats, A.J.S., Anker, S.D., Bayes‐Genis, A., Butler, J., et al. (2023) Natriuretic Peptides: Role in the Diagnosis and Management of Heart Failure: A Scientific Statement from the Heart Failure Association of the European Society of Cardiology, Heart Failure Society of America and Japanese Heart Failure Society. European Journal of Heart Failure, 25, 616-631. [Google Scholar] [CrossRef] [PubMed]
[14] Chow, S.L., Maisel, A.S., Anand, I., Bozkurt, B., de Boer, R.A., Felker, G.M., et al. (2017) Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement from the American Heart Association. Circulation, 135, e1054-e1091. [Google Scholar] [CrossRef] [PubMed]
[15] Zile, M.R., Claggett, B.L., Prescott, M.F., McMurray, J.J.V., Packer, M., Rouleau, J.L., et al. (2016) Prognostic Implications of Changes in N-Terminal Pro-B-Type Natriuretic Peptide in Patients with Heart Failure. Journal of the American College of Cardiology, 68, 2425-2436. [Google Scholar] [CrossRef] [PubMed]
[16] Linssen, G.C.M., Jaarsma, T., Hillege, H.L., Voors, A.A. and van Veldhuisen, D.J. (2018) A Comparison of the Prognostic Value of BNP versus NT-ProBNP after Hospitalisation for Heart Failure. Netherlands Heart Journal, 26, 486-492. [Google Scholar] [CrossRef] [PubMed]
[17] 中国医师协会心力衰竭专业委员会, 国家心血管病专家委员会心力衰竭专业委员会, 中华心力衰竭和心肌病杂志编辑委员会. 心力衰竭生物标志物临床应用中国专家共识[J]. 中华心力衰竭和心肌病杂志, 2022(3): 175-192.
[18] Ndrepepa, G. (2019) Myeloperoxidase—A Bridge Linking Inflammation and Oxidative Stress with Cardiovascular Disease. Clinica Chimica Acta, 493, 36-51. [Google Scholar] [CrossRef] [PubMed]
[19] Ramachandra, C.J.A., Ja, K.P.M.M., Chua, J., Cong, S., Shim, W. and Hausenloy, D.J. (2020) Myeloperoxidase as a Multifaceted Target for Cardiovascular Protection. Antioxidants & Redox Signaling, 32, 1135-1149. [Google Scholar] [CrossRef] [PubMed]
[20] Janus, S.E., Hajjari, J., Chami, T., Karnib, M., Al-Kindi, S.G. and Rashid, I. (2022) Myeloperoxidase Is Independently Associated with Incident Heart Failure in Patients with Coronary Artery Disease and Kidney Disease. Current Problems in Cardiology, 47, Article ID: 101080. [Google Scholar] [CrossRef] [PubMed]
[21] Wang, Y., Jia, Y., Xu, Q., Wang, R., Sun, L., Guo, D., et al. (2023) Association between Myeloperoxidase and the Risks of Ischemic Stroke, Heart Failure, and Atrial Fibrillation: A Mendelian Randomization Study. Nutrition, Metabolism and Cardiovascular Diseases, 33, 210-218. [Google Scholar] [CrossRef] [PubMed]
[22] Avaliani, T., Talakvadze, T. and Tabagari, S. (2019) Prognostic Value of Plasma Myeloperoxidase Level’s and Echocardiographic Determinants in Chronic Heart Failure Patients. Georgian Medical News, No. 288, 55-60.
[23] Tang, W.H.W., Brennan, M., Philip, K., Tong, W., Mann, S., Van Lente, F., et al. (2006) Plasma Myeloperoxidase Levels in Patients with Chronic Heart Failure. The American Journal of Cardiology, 98, 796-799. [Google Scholar] [CrossRef] [PubMed]
[24] Tang, W.H.W., Tong, W., Troughton, R.W., Martin, M.G., Shrestha, K., Borowski, A., et al. (2007) Prognostic Value and Echocardiographic Determinants of Plasma Myeloperoxidase Levels in Chronic Heart Failure. Journal of the American College of Cardiology, 49, 2364-2370. [Google Scholar] [CrossRef] [PubMed]
[25] Wollert, K.C., Kempf, T. and Wallentin, L. (2017) Growth Differentiation Factor 15 as a Biomarker in Cardiovascular Disease. Clinical Chemistry, 63, 140-151. [Google Scholar] [CrossRef] [PubMed]
[26] Claus, R., Berliner, D., Bavendiek, U., Vodovar, N., Lichtinghagen, R., David, S., et al. (2020) Soluble Neprilysin, NT-ProBNP, and Growth Differentiation Factor-15 as Biomarkers for Heart Failure in Dialysis Patients (SONGBIRD). Clinical Research in Cardiology, 109, 1035-1047. [Google Scholar] [CrossRef] [PubMed]
[27] Kosum, P., Siranart, N., Mattanapojanat, N., Phutinart, S., Kongruttanachok, N., Sinphurmsukskul, S., et al. (2024) GDF-15: A Novel Biomarker of Heart Failure Predicts Short-Term and Long-Term Heart-Failure Rehospitalization and Short-Term Mortality in Patients with Acute Heart Failure Syndrome. BMC Cardiovascular Disorders, 24, Article No. 151. [Google Scholar] [CrossRef] [PubMed]
[28] Eggers, K.M. and Lindahl, B. (2017) Application of Cardiac Troponin in Cardiovascular Diseases Other than Acute Coronary Syndrome. Clinical Chemistry, 63, 223-235. [Google Scholar] [CrossRef] [PubMed]
[29] Garg, P., Morris, P., Fazlanie, A.L., Vijayan, S., Dancso, B., Dastidar, A.G., et al. (2017) Cardiac Biomarkers of Acute Coronary Syndrome: From History to High-Sensitivity Cardiac Troponin. Internal and Emergency Medicine, 12, 147-155. [Google Scholar] [CrossRef] [PubMed]
[30] Yafasova, A., Butt, J.H. and Rørth, R. (2021) Troponin: An Important Prognostic Biomarker in Patients with Heart Failure and Reduced Ejection Fraction? European Journal of Heart Failure, 23, 1539-1540. [Google Scholar] [CrossRef] [PubMed]
[31] Felker, G.M., Mentz, R.J., Teerlink, J.R., Voors, A.A., Pang, P.S., Ponikowski, P., et al. (2015) Serial High Sensitivity Cardiac Troponin T Measurement in Acute Heart Failure: Insights from the RELAX‐AHF Study. European Journal of Heart Failure, 17, 1262-1270. [Google Scholar] [CrossRef] [PubMed]
[32] Jaffe, A.S. and Miller, W.L. (2018) Meta-Analyses and Interpretation of Troponin Values in Heart Failure. JACC: Heart Failure, 6, 198-200. [Google Scholar] [CrossRef] [PubMed]
[33] Kilpatrick, E.S. (2022) Cardiac Troponin as a Marker of Heart Failure Risk in Diabetes. Clinical Chemistry, 68, 1232-1234. [Google Scholar] [CrossRef] [PubMed]
[34] Lokaj, P., Spinar, J., Spinarova, L., Malek, F., Ludka, O., Krejci, J., et al. (2021) Prognostic Value of High-Sensitivity Cardiac Troponin I in Heart Failure Patients with Mid-Range and Reduced Ejection Fraction. PLOS ONE, 16, e0255271. [Google Scholar] [CrossRef] [PubMed]
[35] Dale, M. and Nicklin, M.J.H. (1999) Interleukin-1 Receptor Cluster: Gene Organization of IL1R2, IL1R1, IL1RL2 (IL-1Rrp2), IL1RL1 (T1/ST2), and IL18R1 (IL-1Rrp) on Human Chromosome 2q. Genomics, 57, 177-179. [Google Scholar] [CrossRef] [PubMed]
[36] Maisel, A.S. and Di Somma, S. (2016) Do We Need Another Heart Failure Biomarker: Focus on Soluble Suppression of Tumorigenicity 2 (sST2). European Heart Journal, 38, 2325-2333. [Google Scholar] [CrossRef] [PubMed]
[37] Sciatti, E., Merlo, A., Scangiuzzi, C., Limonta, R., Gori, M., D’Elia, E., et al. (2023) Prognostic Value of sST2 in Heart Failure. Journal of Clinical Medicine, 12, Article 3970. [Google Scholar] [CrossRef] [PubMed]
[38] Kotsiou, O.S., Gourgoulianis, K.I. and Zarogiannis, S.G. (2018) IL-33/ST2 Axis in Organ Fibrosis. Frontiers in Immunology, 9, Article 2432. [Google Scholar] [CrossRef] [PubMed]
[39] Vergaro, G., Gentile, F., Aimo, A., Januzzi, J.L., Richards, A.M., Lam, C.S.P., et al. (2022) Circulating Levels and Prognostic Cut‐offs of sST2, hs-cTnT, and NT-proBNP in Women vs. Men with Chronic Heart Failure. ESC Heart Failure, 9, 2084-2095. [Google Scholar] [CrossRef] [PubMed]
[40] Mueller, T., Gegenhuber, A., Leitner, I., Poelz, W., Haltmayer, M. and Dieplinger, B. (2016) Diagnostic and Prognostic Accuracy of Galectin-3 and Soluble ST2 for Acute Heart Failure. Clinica Chimica Acta, 463, 158-164. [Google Scholar] [CrossRef] [PubMed]
[41] Jin, X., Huang, N., Shang, H., Zhou, M., Hong, Y., Cai, W., et al. (2017) Diagnosis of Chronic Heart Failure by the Soluble Suppression of Tumorigenicity 2 and N‐Terminal Pro‐Brain Natriuretic Peptide. Journal of Clinical Laboratory Analysis, 32, e22295. [Google Scholar] [CrossRef] [PubMed]
[42] Gül, İ. (2017) Prognostic Role of Soluble Suppression of Tumorigenicity-2 on Cardiovascular Mortality in Outpatients with Heart Failure. The Anatolian Journal of Cardiology, 18, 200-205. [Google Scholar] [CrossRef] [PubMed]
[43] Dong, G., Chen, H., Zhang, H. and Gu, Y. (2021) Long-Term and Short-Term Prognostic Value of Circulating Soluble Suppression of Tumorigenicity-2 Concentration in Chronic Heart Failure: A Systematic Review and Meta-Analysis. Cardiology, 146, 433-440. [Google Scholar] [CrossRef] [PubMed]
[44] Scholler, N. and Urban, N. (2007) CA125 in Ovarian Cancer. Biomarkers in Medicine, 1, 513-523. [Google Scholar] [CrossRef] [PubMed]
[45] Núñez, J., de la Espriella, R., Miñana, G., Santas, E., Llácer, P., Núñez, E., et al. (2021) Antigen Carbohydrate 125 as a Biomarker in Heart Failure: A Narrative Review. European Journal of Heart Failure, 23, 1445-1457. [Google Scholar] [CrossRef] [PubMed]
[46] Zhang, M., Zhang, Y., Fu, J. and Zhang, L. (2019) Serum CA125 Levels Are Decreased in Rectal Cancer but Increased in Fibrosis-Associated Diseases and in Most Types of Cancers. Progress in Molecular Biology and Translational Science, 162, 241-252. [Google Scholar] [CrossRef] [PubMed]
[47] Llàcer, P., Bayés-Genís, A. and Núñez, J. (2019) Antígeno carbohidrato 125 en insuficiencia cardiaca. Nueva era en la monitorización y control del tratamiento. Medicina Clínica, 152, 266-273. [Google Scholar] [CrossRef] [PubMed]
[48] Núñez, J., Miñana, G., Núñez, E., Chorro, F.J., Bodí, V. and Sanchis, J. (2013) Clinical Utility of Antigen Carbohydrate 125 in Heart Failure. Heart Failure Reviews, 19, 575-584. [Google Scholar] [CrossRef] [PubMed]
[49] Feng, R., Zhang, Z. and Fan, Q. (2023) Carbohydrate Antigen 125 in Congestive Heart Failure: Ready for Clinical Application? Frontiers in Oncology, 13, Article 1161723. [Google Scholar] [CrossRef] [PubMed]
[50] Zhang, J., Li, W., Xiao, J., Hui, J. and Li, Y. (2023) Prognostic Significance of Carbohydrate Antigen 125 in Stage D Heart Failure. BMC Cardiovascular Disorders, 23, Article No. 108. [Google Scholar] [CrossRef] [PubMed]
[51] Castiglione, V., Vergaro, G., Aimo, A., et al. (2021) Biomarkers for the Diagnosis and Management of Heart Failure: Natriuretic Peptides. Giornale Italiano di Cardiologia, 22, 292-300.