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首页> 外文期刊>Heart failure reviews >The utility of growth differentiation factor-15, galectin-3, and sST2 as biomarkers for the diagnosis of heart failure with preserved ejection fraction and compared to heart failure with reduced ejection fraction: a systematic review
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The utility of growth differentiation factor-15, galectin-3, and sST2 as biomarkers for the diagnosis of heart failure with preserved ejection fraction and compared to heart failure with reduced ejection fraction: a systematic review

机译:生长分化因子-15,Galectin-3和SST2作为生物标志物的效用,用于诊断心力衰竭,与保存的喷射分数相比,与射血分数减少的心力衰竭相比:系统评价

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摘要

The objective was to evaluate the diagnosis of heart failure with preserved ejection fraction (HFpEF) using the biomarkers, growth differentiation factor-15 (GDF-15), galectin-3 (Gal-3), and soluble ST2 (sST2), and to determine whether they can differentiate HFpEF from heart failure with reduced ejection fraction (HFrEF). Medline and Embase databases were searched with the terms diastolic heart failure or HFpEF, biomarkers, and diagnosis, limited to years 2000 to 2019. There were significantly and consistently higher levels of GDF-15, Gal-3, and sST2 in HFpEF compared to no heart failure. Importantly, the magnitude of the increase in GDF-15 or Gal-3 and possibly sST2,correlated with a greater degree of diastolic dysfunction. There were no significant differences between GDF-15, Gal-3, and sST2 in patients with HFpEF vs HFrEF. In the studies assessing these three biomarkers, BNP was significantly greater in heart failure than controls. Furthermore, BNP was significantly higher in HFrEF compared to HFpEF. The diagnostic utility of GDF-15, Gal-3, and sST2 compared to BNP was evaluated by comparing ROC curves. The data supports the contention that to distinguish HFpEF from HFrEF, an index is needed that incorporates GDF-15, Gal-3, or sST2 as well as BNP. The three biomarkers GDF-15, Gal-3, or sST2 can identify patients with HFpEF compared to individuals without heart failure but cannot differentiate HFpEF from HFrEF. BNP is higher in and is better at differentiating HFrEF from HFpEF. Indices that incorporate GDF-15, Gal-3, or sST2 as well as BNP show promise in differentiating HFpEF from HFrEF.
机译:目的是利用生物标志物生长分化因子-15(GDF-15)、半乳糖凝集素-3(Gal-3)和可溶性ST2(sST2)评估射血分数保留(HFpEF)心力衰竭的诊断,并确定它们是否能区分HFpEF和射血分数降低的心力衰竭(HFrEF)。Medline和Embase数据库使用舒张性心力衰竭或HFpEF、生物标志物和诊断等术语进行搜索,搜索期限为2000年至2019年。与无心力衰竭患者相比,HFpEF患者的GDF-15、Gal-3和sST2水平显著且持续升高。重要的是,GDF-15或Gal-3以及sST2增加的幅度与舒张功能障碍的更大程度相关。在HFpEF患者和HFrEF患者中,GDF-15、Gal-3和sST2之间没有显著差异。在评估这三种生物标志物的研究中,心力衰竭患者的BNP显著高于对照组。此外,与HFpEF相比,HFrEF患者的BNP显著升高。通过比较ROC曲线评估GDF-15、Gal-3和sST2与BNP的诊断价值。数据支持这样一种观点,即为了区分HFpEF和HFrEF,需要一个包含GDF-15、Gal-3或sST2以及BNP的索引。三种生物标记物GDF-15、Gal-3或sST2可以识别HFpEF患者与无心力衰竭患者,但不能区分HFpEF和HFrEF。BNP在肾功能衰竭中较高,并且在区分HFrEF和HFpEF方面更好。包含GDF-15、Gal-3或sST2以及BNP的指数显示了区分HFpEF和HFrEF的前景。

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