期刊
APPLIED SCIENCES-BASEL
卷 11, 期 10, 页码 -出版社
MDPI
DOI: 10.3390/app11104397
关键词
heart failure; heart failure with reduced ejection fraction; heart failure with preserved ejection fraction; diabetes mellitus; circulating biomarkers; prognosis
Heart failure and type 2 diabetes mellitus have a synergistic effect on cardiovascular morbidity and mortality in patients with established cardiovascular disease. While conventional biomarkers show limited predictive ability in HFpEF, novel biomarkers may improve risk stratification and prediction of poor outcomes in these patients. Further research in large clinical trials is required to elucidate the role of novel biomarkers in point-of-care and routine practice for T2DM patients with HF.
Heart failure (HF) and type 2 diabetes mellitus (T2DM) have a synergistic effect on cardiovascular (CV) morbidity and mortality in patients with established CV disease (CVD). The aim of this review is to summarize the knowledge regarding the discriminative abilities of conventional and novel biomarkers in T2DM patients with established HF or at higher risk of developing HF. While conventional biomarkers, such as natriuretic peptides and high-sensitivity troponins demonstrate high predictive ability in HF with reduced ejection fraction (HFrEF), this is not the case for HF with preserved ejection fraction (HFpEF). HFpEF is a heterogeneous disease with a high variability of CVD and conventional risk factors including T2DM, hypertension, renal disease, older age, and female sex; therefore, the extrapolation of predictive abilities of traditional biomarkers on this population is constrained. New biomarker-based approaches are disputed to be sufficient for improving risk stratification and the prediction of poor clinical outcomes in patients with HFpEF. Novel biomarkers of biomechanical stress, fibrosis, inflammation, oxidative stress, and collagen turn-over have shown potential benefits in determining prognosis in T2DM patients with HF regardless of natriuretic peptides, but their role in point-to-care and in routine practice requires elucidation in large clinical trials.
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