Arif Albulushi , Jehad Al Buraiki , Gamal Aly , Yahya Al-Wahshi , Alireza Jahangirifard
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引用次数: 0
摘要
背景：心脏淀粉样变性的特点是淀粉样纤维沉积在心脏中，导致局限性心肌病和心力衰竭。早期诊断和监测对有效治疗至关重要。本系统综述和荟萃分析评估了各种生物标志物在心脏淀粉样变性的早期检测、疾病进展和预后方面的作用：我们在PubMed、Scopus和Web of Science数据库中全面检索了2000年至2024年间发表的评估心脏淀粉样变性生物标志物诊断和预后价值的研究。通过提取和分析数据，确定了每种生物标志物的敏感性、特异性和预后意义。此外，还探讨了生物标志物水平与影像学检查结果之间的相关性：荟萃分析共纳入了 45 项研究。NT-proBNP和肌钙蛋白对早期诊断心脏淀粉样变性具有较高的敏感性和特异性。新型生物标志物，如血清淀粉样蛋白P成分和轻链测定，在区分淀粉样变性亚型和预测疾病进展方面显示出前景。然而，生物标志物与成像结果之间的相关性存在很大差异：结论：生物标志物对心脏淀粉样变性的早期诊断和预后至关重要。结论：生物标记物对早期诊断和预后至关重要。NT-proBNP 和肌钙蛋白是公认的标记物，而新型生物标记物则为疾病进展和亚型分化提供了更多的见解。
Role of biomarkers in early diagnosis and prognosis of cardiac amyloidosis: A systematic review and meta-analysis
Background
Cardiac amyloidosis is characterized by amyloid fibril deposition in the heart, leading to restrictive cardiomyopathy and heart failure. Early diagnosis and monitoring are crucial for effective management. This systematic review and meta-analysis evaluates the utility of various biomarkers in the early detection, disease progression, and prognosis of cardiac amyloidosis.
Methods
We conducted a comprehensive search of PubMed, Scopus, and Web of Science databases for studies published between 2000 and 2024 that assessed the diagnostic and prognostic value of biomarkers in cardiac amyloidosis. Data were extracted and analyzed to determine the sensitivity, specificity, and prognostic significance of each biomarker. The correlation between biomarker levels and imaging findings was also explored.
Results
A total of 45 studies were included in the meta-analysis. NT-proBNP and troponins had high sensitivity and specificity for early diagnosis of cardiac amyloidosis. Novel biomarkers, such as serum amyloid P component and light-chain assays, showed promise in distinguishing between amyloidosis subtypes and predicting disease progression. However, significant variability existed in the correlation between biomarkers and imaging findings.
Conclusions
Biomarkers are crucial for early diagnosis and prognosis of cardiac amyloidosis. NT-proBNP and troponins are well-established markers, while novel biomarkers offer additional insights into disease progression and subtype differentiation.
期刊介绍：
Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.
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