Abstract
Studies in recent years have shown increased interest in developing new methods of evaluation, but also in limiting post infarction ventricular remodeling, hoping to improve ventricular function and the further evolution of the patient. This is the point where biomarkers have proven effective in early detection of remodeling phenomena. There are six main processes that promote the remodeling and each of them has specific biomarkers that can be used in predicting the evolution (myocardial necrosis, neurohormonal activation, inflammatory reaction, hypertrophy and fibrosis, apoptosis, mixed processes). Some of the biomarkers such as creatine kinase–myocardial band (CK-MB), troponin, and N-terminal-pro type B natriuretic peptide (NT-proBNP) were so convincing that they immediately found their place in the post infarction patient evaluation protocol. Others that are related to more complex processes such as inflammatory biomarkers, atheroma plaque destabilization biomarkers, and microRNA are still being studied, but the results so far are promising. This article aims to review the markers used so far, but also the existing data on new markers that could be considered, taking into consideration the most important studies that have been conducted so far.
Highlights
Cardiovascular diseases represent a leading cause of death, accounting for 30% of deaths worldwide
No other neuropeptide besides B natriuretic peptide (BNP) and NT-proBNP is routinely used in practical evaluation, there is indirect evidence of their ability to predict morbidity and mortality in patients with infarction by decreasing it in patients treated with renin–angiotensin–aldosterone system (RAAS) inhibitors [77,78] Some studies have shown that a higher renin/aldosterone ratio is correlated with higher chances of developing ventricular remodeling [79]
These are controlled by hormonal discharges, growth factors, and cytokines secreted by inflammatory cells and by tissue inhibitors of metalloproteinase (TIMPs), which are the main regulators for the proteolytic activity [118]
Summary
Cardiovascular diseases represent a leading cause of death, accounting for 30% of deaths worldwide. In the context of current knowledge, studies in recent years have shown increased interest in developing new methods of evaluation, and in limiting post-infarction ventricular remodeling, hoping to improve ventricular function and the further evolution of the patient. This is the point where biomarkers have proven effective in early detection of remodeling phenomena, some of them being so convincing that they immediately found their place in the post-infarction patient evaluation protocol. This article aims to review the markers used so far, and the existing data on new markers that could be considered, in order to see the biomarkers that approach the characteristics of an ideal biomarker
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