Cardiac Biomarkers in Advanced Heart Failure: How Can They Impact Our Pre-transplant or Pre-LVAD Decision-making
Cardiac Biomarkers in Advanced Heart Failure: How Can They Impact Our Pre-transplant or Pre-LVAD Decision-making
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DOI：
10.1007/s11897-019-00447-w
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发表时间：
2019-12-01
影响因子：
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通讯作者：
Breathett, Khadijah
中科院分区：
文献类型：
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作者：
Ebong, Imo;Mazimba, Sula;Breathett, Khadijah
综述目的晚期心力衰竭（HF）的决策是一个复杂的过程，涉及到仔细考虑心脏移植（HT）或左心室辅助装置（LVAD）放置的风险和受益的竞争权衡。这篇综述的目的是讨论生物标志物如何影响HT或LVAD植入的决策。最新发现N-末端前体蛋白利钠肽、可溶性致瘤性抑制-2、半乳糖凝集素-3、和肽素和肌钙蛋白T水平与HF生存相关，可帮助确定晚期HF治疗的适当时机。LVAD植入后存在右心室衰竭风险的患者可以通过植入前细胞外基质更新、神经激素激活和炎症的生物标志物进行识别。在晚期HF治疗分配中采用生物标志物测量进行决策的数据有限。尽管如此，生物标志物可以改善风险分层和诊断，从而优化HT和LVAD植入的患者选择。
Purpose of Review Decision-making in advanced heart failure (HF) is a complex process that involves careful consideration of competing tradeoffs of risks and benefits in regard to heart transplantation (HT) or left ventricular assist device (LVAD) placement. The purpose of this review is to discuss how biomarkers may affect decision-making for HT or LVAD implantation. Recent Findings N-Terminal probrain natriuretic peptide, soluble suppression of tumorigenicity-2, galectin-3, copeptin, and troponin T levels are associated with HF survival and can help identify the appropriate timing for advanced HF therapies. Patients at risk of right ventricular failure after LVAD implantation can be identified with preimplant biomarkers of extracellular matrix turnover, neurohormonal activation, and inflammation. There is limited data on the adoption of biomarker measurement for decision-making in the allocation of advanced HF therapies. Nonetheless, biomarkers can improve risk stratification and prognostication thereby optimizing patient selection for HT and LVAD implantation.