ESC心衰流行病学进展以及生物学标记物的作用+MCC.ppt

总结：我们需要生物标记物的几个方面 诊断：(NT-pro)BNP 常规使用 预后判断： 有大量发表的文章， 涌现众多标记物， 单一标记物在临床指标基础上的预测价值有限， 可以考虑多个标记物的策略 生物标记物指导的治疗：临床研究结果仍然不完全一致 精准医疗：前景很好，但是路途依然很长 * Biomarkers will Make bad doctors worse and good doctors better! * 日本东北地区的慢性心衰分析和登记研究（CHART研究）。共包含两个数据库，从2002年至2005年12月为CHART-1研究的数据库，入选的是1278例的LVEF50%，LVDd≥55mm的有心衰病史的慢性心衰患者。从2006年10月到目前，研究进入了第二个阶段（CHART-2研究），除了入选C/D期的心衰患者之外，还入选了A/B期的患者，研究目标从心衰治疗和预后扩展到心衰的预防。 本次ESC 发布的结果是基于对来自两个数据库的4682例有症状的CHF患者的数据进行的分析。目的是比较今年来日本心衰患者的基线特征、治疗情况和预后的变化。 * 卡帕多西亚（Cappadocia），位于土耳其中部的卡帕多西亚以其童话般的斑点岩层而闻名：奇特的岩石构造、岩洞和半隐居人群的历史遗迹令人神往。这里起初是基督教徒躲避罗马迫害的避难处，公元4世纪，一群僧侣建立了卡帕多西亚的主要部分。 土耳其的卡帕多西亚，它被美国《国家地理》杂志社评选为十大地球美景之一。是地球上最适合乘热气球的两个地方之一。 * IL-33/ST2 signalling is a novel cardioprotective fibroblast–cardiomyocyte paracrine system In 2002, using microarrays, our laboratory noted that the transcript for ST2 was markedly upregulated in mechanically-stimulated cardiomyocytes. Both the transmembrane and soluble forms of ST2 were induced, with the soluble form displaying more robust expression80 sST2 as a decoy receptor when elevated binds IL-33, effectively reducing the concentration of IL-33 that is available to ST2L, thus diminishing the cardioprotective effect of IL-33. * OBJECTIVES: The purpose of this study was to examine the patient-specific characteristics of the interleukin-1 receptor family member ST2 in patients with acute heart failure (HF). METHODS: In all, 346 patients with acute HF had ST2 measured. Associations between ST2 and demographics, severity/type of HF, and other biomarkers were examined. * * BATCH研究(Biomarkers in Acute Heart Failure)： a prospective, international, study of 1641 patients presenting to EDs with dyspnoea. Blood samples were analysed for PCT and other biomarkers. Relevant clinical data were also captured. Patient outcomes were assessed at 90 days. The diagnosis of pneumonia was made using strictly validated guidelines. A model using PCT was more accurate [area under the curve (AUC) 72.3%] than any other individual clini