摘要
急性心脏条件、人口老龄化、生活方式相关的风险因素的流行和心力衰竭(HF)治疗的进步等条件的改善,导致了HF的发病率不断增长。HF目前被认为是发达国家公共卫生的重点和发展中国家的一种重大非传染性综合症。心力衰竭是一种具有多种病理生理机制的复杂综合症。炎症,一种体内平衡的组成部分,是对刺激源的一种复杂的组织应答,试图减轻它们的效应和启动治疗。炎症在HF的发展、过程、严重程度和结果中发挥着至关重要的作用。致炎和抗炎过程之间这种微妙的平衡可能对心力衰竭产生有利或不利的影响。本文综述了炎症生物标记及其在HF患者预后和治疗过程中潜在作用的证据。虽然试图直接破坏HF炎症级联反应,因其缺乏有效性和潜在伤害已基本被放弃,在我们的知识水平上也还存在着很大的空白。尽管炎症生物标记水平与HF的严重程度及并发症有着强大的关联,某些特定标记及途径与HF特定的类型或方面之间的因果联系还有待阐明。当被用作与其他风险因素结合的治疗反应标记,炎症标记具有改善HF病人风险分级和个性化治疗HF的潜能,其最终目标是改善这些患者的生活质量和延长他们的生命。
关键词: 生物标记物,心力衰竭,炎症,预后,治疗。
Current Medicinal Chemistry
Title:Inflammatory Biomarkers and Therapeutic Targets in Heart Failure
Volume: 22 Issue: 23
Author(s): Lampros Papadimitriou and Andreas P. Kalogeropoulos
Affiliation:
关键词: 生物标记物,心力衰竭,炎症,预后,治疗。
摘要: Improved outcomes of acute cardiac conditions, population aging, prevalent lifestyle-related risk factors, and advances in heart failure (HF) therapy, all have led to an ever-increasing prevalence of HF, currently considered a public health priority in developed countries and a major noncommunicable syndrome in developing regions. Heart failure is a complex syndrome with a host of pathophysiological mechanisms in action. Inflammation, an integral component of homeostasis, is a complex tissue response to stressors that attempts to mitigate their effect and initiate healing. Inflammation plays a critical role in the development, course, severity and outcomes of HF. The delicate balance of pro- and antiinflammatory processes can lead to beneficial or detrimental effects to the failing heart. In this article, we review the evidence on inflammatory biomarkers and their potential role in prognosis and therapeutic decisions for patients with HF. Although attempts to directly disrupt the inflammatory cascade in HF have been largely abandoned due to lack of efficacy and potential harm, there are still important gaps in our knowledge. Despite the strong association of levels of inflammatory biomarkers with HF severity and comorbidities, the causal association of certain markers and pathways with specific types or aspects of HF remains to be elucidated. When used as treatment response markers in conjunction with other risk factors, inflammatory markers have the potential to improve risk stratification of patients with HF and personalize HF treatment, with the ultimate goal to improve quality of life and prolong survival in these patients.
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Cite this article as:
Lampros Papadimitriou and Andreas P. Kalogeropoulos , Inflammatory Biomarkers and Therapeutic Targets in Heart Failure, Current Medicinal Chemistry 2015; 22 (23) . https://dx.doi.org/10.2174/0929867322666150415152532
DOI https://dx.doi.org/10.2174/0929867322666150415152532 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
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