Shared biomarkers between female diastolic heart failure and pre-eclampsia: a systematic review and meta-analysis.
Shared biomarkers between female diastolic heart failure and pre-eclampsia: a systematic review and meta-analysis.
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DOI：
10.1002/ehf2.12129
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发表时间：
2017-05
影响因子：
3.8
通讯作者：
de Groot CJM
中科院分区：
文献类型：
--
作者：
Alma LJ;Bokslag A;Maas AHEM;Franx A;Paulus WJ;de Groot CJM
越来越多的证据表明妊娠期高血压疾病与后期心血管风险增加之间存在关联。本研究的主要目的是探索代表保留射血分数心力衰竭（HFpEF）和先兆子痫之间共同致病途径的共享生物标志物，这些生物标志物可能有潜在的资格用于高血压妊娠障碍后妇女的心血管风险分层。我们在第一次文献检索中寻找舒张功能障碍女性的血液标志物，通过第二次文献检索，我们研究了这些相同的生化标志物是否存在于先兆子痫中。该系统综述和荟萃分析提出了PubMed和EMBASE中随后的两个系统搜索。检索I获得3014项区分HFpEF女性与女性对照的生物标志物研究，其中包括13项关于11项生化标志物的研究。病例有HFpEF，对照组无心力衰竭。第二次检索是针对区分先兆子痫妇女和非高血压妊娠妇女的研究，其中至少有一种生物标志物在检索i中发现。检索II获得了1869项研究，其中51项关于7种生物标志物的研究被纳入meta分析，79项关于12种生物标志物的研究被纳入系统评价。11种生物标志物将舒张功能障碍妇女与对照组区分开来，其中以下10种标志物也将子痫前期妇女与对照组区分开来：C反应蛋白、HDL、胰岛素、脂肪酸结合蛋白4、脑钠肽、N端前脑钠肽、肾上腺髓质素、中部前肾上腺髓质素、心肌肌钙蛋白I和癌症抗原125。我们的研究支持女性HFpEF与先兆子痫具有共同致病背景的假设。代表炎症状态、心肌功能/结构紊乱和不利脂质代谢的生物标志物可能有资格作为未来的预后工具。
Evidence accumulates for associations between hypertensive pregnancy disorders and increased cardiovascular risk later. The main goal of this study was to explore shared biomarkers representing common pathogenic pathways between heart failure with preserved ejection fraction (HFpEF) and pre‐eclampsia where these biomarkers might be potentially eligible for cardiovascular risk stratification in women after hypertensive pregnancy disorders. We sought for blood markers in women with diastolic dysfunction in a first literature search, and through a second search, we investigated whether these same biochemical markers were present in pre‐eclampsia.This systematic review and meta‐analysis presents two subsequent systematic searches in PubMed and EMBASE. Search I yielded 3014 studies on biomarkers discriminating women with HFpEF from female controls, of which 13 studies on 11 biochemical markers were included. Cases had HFpEF, and controls had no heart failure. The second search was for studies discriminating women with pre‐eclampsia from women with non‐hypertensive pregnancies with at least one of the biomarkers found in Search I. Search II yielded 1869 studies, of which 51 studies on seven biomarkers were included in meta‐analyses and 79 studies on 12 biomarkers in systematic review.Eleven biological markers differentiated women with diastolic dysfunction from controls, of which the following 10 markers differentiated women with pre‐eclampsia from controls as well: C‐reactive protein, HDL, insulin, fatty acid‐binding protein 4, brain natriuretic peptide, N terminal pro brain natriuretic peptide, adrenomedullin, mid‐region pro adrenomedullin, cardiac troponin I, and cancer antigen 125.Our study supports the hypothesis that HFpEF in women shares a common pathogenic background with pre‐eclampsia. The biomarkers representing inflammatory state, disturbances in myocardial function/structure, and unfavourable lipid metabolism may possibly be eligible for future prognostic tools.