Revisiting Biomarkers of Cardiac Allograft Vasculopathy: Addressing the Achilles Heel of Heart Transplantation.

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Current Heart Failure Reports Pub Date : 2024-12-01 Epub Date: 2024-10-17 DOI:10.1007/s11897-024-00685-7
Patrick E O'Hara, Ananya Gorrai, Maryjane Farr, Matthias Peltz, Hadi Beaini, Yasbanoo Moayedi, Sharon Chih, Lauren K Truby
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Abstract

Nearly half of heart transplant recipients will be diagnosed with cardiac allograft vasculopathy (CAV) within five years after transplantation. Advanced CAV can lead to worsening heart failure as well as arrhythmias and sudden cardiac death. The only curative therapy for end-stage CAV is re-transplantation. Current diagnostic methods are invasive and limited by poor sensitivity in early disease. Despite its high prevalence in the post-transplantpopulation, the underlying pathophysiology of this condition has yet to be fully described. It is thought to be primarily related to endothelial dysfunction, immune activation, and cardiometabolic disease. Biomarkers reflecting these underlying processes, particularly endothelial injury and immune activation, have shown early promise in discriminating prevalent CAV. Next-generation sequencing technologies such as proteomic and transcriptomic profiling have also provided further insight into the pathophysiology of CAV through the identification of novel biomarkers. Ultimately, these biomarkers may have a role in not only diagnosing CAV but also highlighting potential targets for disease-specific therapies. In this article, we review the current data for biomarkers in CAV and discuss future directions for biomarker identification..

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重新审视心脏移植血管病变的生物标志物:解决心脏移植的致命弱点。
近一半的心脏移植受者会在移植后五年内被诊断出患有心脏同种异体移植血管病变(CAV)。晚期 CAV 可导致心力衰竭恶化、心律失常和心脏性猝死。对终末期 CAV 的唯一治疗方法是再次移植。目前的诊断方法都是侵入性的,对早期疾病的敏感性较低。尽管 CAV 在移植后人群中发病率很高,但其潜在的病理生理学尚未得到充分描述。人们认为它主要与内皮功能障碍、免疫激活和心脏代谢疾病有关。反映这些潜在过程(尤其是内皮损伤和免疫激活)的生物标志物在鉴别流行性 CAV 方面已初见成效。蛋白质组和转录组分析等下一代测序技术也通过鉴定新型生物标志物进一步深入了解了 CAV 的病理生理学。最终,这些生物标志物不仅可用于诊断 CAV,还能突出疾病特异性疗法的潜在靶点。在本文中,我们回顾了 CAV 生物标志物的现有数据,并讨论了生物标志物鉴定的未来方向。
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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
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.
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