Biomarkers of Hemodynamic Congestion in Heart Failure.

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Heart Failure Reports Pub Date : 2024-12-01 Epub Date: 2024-09-19 DOI:10.1007/s11897-024-00684-8

Alison Brann, Sean Selko, Ethan Krauspe, Kevin Shah

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引用次数: 0

Abstract

Purpose of review: The purpose of this review is to describe the evidence behind various blood and imaging-based biomarkers that can improve the identification of congestion when not clearly evident on routine examination.

Recent findings: The natriuretic peptides (NPs) BNP and NT-proBNP have been shown to closely correlate with intra-cardiac filling pressures, both at baseline and when trended following improvement in congestion. Additionally, NPs rise well before clinical congestion is apparent so can be used as a tool to help identify subclinical HF decompensation. Additional serum-based biomarkers including MR-proANP and CA-125 can be helpful in assisting with diagnostic certainty when BNP or NT-proBNP are in the "grey zone" or when factors are present which may confound NP levels. Additionally, the emerging use of ultrasound techniques may enhance our ability to fine-tune the assessment and treatment of congestion. Biomarkers, including the blood-based natriuretic peptides and markers on bedside point of care ultrasound, can be used as non-invasive indices of hemodynamic congestion. These biomarkers are particularly valuable to incorporate when the degree of a patient's congestion is not apparent on clinical exam, and they can provide important prognostic information and help guide clinical management.

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心力衰竭血流动力学充盈的生物标志物

综述目的：本综述旨在描述各种基于血液和成像的生物标志物背后的证据，这些生物标志物可以在常规检查不明显的情况下提高充血的识别率：最近的研究结果表明，无论是基线还是充血改善后的趋势，钠尿肽（NPs）BNP 和 NT-proBNP 都与心内充盈压密切相关。此外，NPs 早在临床充血明显之前就已升高，因此可作为帮助识别亚临床 HF 失代偿的工具。当 BNP 或 NT-proBNP 处于 "灰色区域 "或存在可能混淆 NP 水平的因素时，其他基于血清的生物标志物（包括 MR-proANP 和 CA-125）可帮助确定诊断。此外，超声技术的新兴应用可能会提高我们对充血评估和治疗进行微调的能力。生物标志物，包括血液中的钠尿肽和床旁护理点超声上的标志物，可用作血流动力学充血的无创指标。当患者的充血程度在临床检查中并不明显时，这些生物标志物就显得尤为重要，它们可以提供重要的预后信息，帮助指导临床治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Heart Failure Reports Medicine-Emergency Medicine

CiteScore

5.30

自引率

0.00%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.