Diagnostic and prognostic value of circulating biomarkers in heart failure.

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Frontiers in Cardiovascular Medicine Pub Date : 2025-09-24 eCollection Date: 2025-01-01 DOI:10.3389/fcvm.2025.1633164
Artur Kovenskiy, Zhussipbek Mukhatayev, Aliya Sailybayeva, Makhabbat Bekbossynova, Almagul Kushugulova
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引用次数: 0

Abstract

Background: Heart failure (HF) represents a global health burden with distinct phenotypes characterized by varying left ventricular ejection fraction (LVEF). Despite shared endothelial dysfunction, heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF) exhibit fundamentally different pathophysiological mechanisms, comorbidity profiles, and treatment responses.

Methods: This systematic review and meta-analysis examine inflammatory, cardiac remodelling and congestion, and myocardial injury biomarkers across HF phenotypes, integrating data from 78 studies encompassing 58,076 subjects.

Results: Our analysis reveals a significant elevation of IL-6, TNF-alpha, and hs-CRP in HF compared to controls, with distinct biomarker profiles emerging between phenotypes. While inflammatory markers universally increase with disease severity, their utility in phenotypic differentiation remains limited due to substantial overlap. Comorbidity burden significantly influences inflammatory profiles, creating diagnostic challenges that multi-biomarker approaches may address. NT-proBNP, sST2, GDF-15, and cardiac troponins demonstrate complementary value when combined with inflammatory markers, potentially enabling more precise phenotypic classification.

Conclusion: Our findings highlight the central role of inflammation in HF pathophysiology while identifying critical knowledge gaps, particularly regarding HFpEF-specific inflammatory signatures. This comprehensive analysis provides a foundation for developing targeted immunomodulatory therapies and personalized diagnostic approaches in heart failure management.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025639405, PROSPERO CRD42025639405.

循环生物标志物在心力衰竭中的诊断和预后价值。
背景:心力衰竭(HF)是一种全球性的健康负担,其不同的表型以不同的左心室射血分数(LVEF)为特征。尽管存在相同的内皮功能障碍,但心力衰竭降低(HFrEF)和保留射血分数(HFpEF)表现出根本不同的病理生理机制、合并症概况和治疗反应。方法:本系统综述和荟萃分析分析了HF表型中的炎症、心脏重构和充血以及心肌损伤生物标志物,整合了78项研究的数据,涵盖58,076名受试者。结果:我们的分析显示,与对照组相比,HF患者IL-6、tnf - α和hs-CRP显著升高,不同表型之间出现不同的生物标志物谱。虽然炎症标志物普遍随着疾病严重程度的增加而增加,但由于大量重叠,它们在表型分化中的效用仍然有限。合并症负担显著影响炎症特征,创造了多生物标志物方法可能解决的诊断挑战。NT-proBNP、sST2、GDF-15和心脏肌钙蛋白在与炎症标志物结合时显示出互补价值,可能实现更精确的表型分类。结论:我们的研究结果强调了炎症在HF病理生理中的核心作用,同时确定了关键的知识空白,特别是关于hfpef特异性炎症特征。这一综合分析为开发靶向免疫调节疗法和心衰管理的个性化诊断方法提供了基础。系统评价注册:https://www.crd.york.ac.uk/PROSPERO/view/CRD42025639405, PROSPERO CRD42025639405。
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
Frontiers in Cardiovascular Medicine
Frontiers in Cardiovascular Medicine Medicine-Cardiology and Cardiovascular Medicine
CiteScore
3.80
自引率
11.10%
发文量
3529
审稿时长
14 weeks
期刊介绍: Frontiers? Which frontiers? Where exactly are the frontiers of cardiovascular medicine? And who should be defining these frontiers? At Frontiers in Cardiovascular Medicine we believe it is worth being curious to foresee and explore beyond the current frontiers. In other words, we would like, through the articles published by our community journal Frontiers in Cardiovascular Medicine, to anticipate the future of cardiovascular medicine, and thus better prevent cardiovascular disorders and improve therapeutic options and outcomes of our patients.
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