张嘉璇,林蓉香,张家豪

心律失常是一种常见的心血管疾病，与高发病率和死亡率密切相关。以往的研究表明，利钠肽（包括脑钠肽、N端脑利钠肽前体、中区域前心房利钠肽）、肌钙蛋白和炎症等因素与心律失常的发生和发展密切相关。近年来，随着心律失常病理生理学研究的深入，发现纤维化和自身免疫标志物可能通过干扰成纤维细胞激活相关的电重构或心脏离子通道的功能，进而导致心律失常的发生和发展。检测这些标志物有助于提供早期诊断、疾病分型和预后预测的信息。本综述的目的在于系统地总结近年来关于心律失常新型生物标志物的研究进展，以期为临床诊疗提供更准确、更可靠的辅助信息。

心律失常；心房颤动；生物标志物

[1] Richards M,Di Somma S,Mueller C,et al.Atrial fibrillation impairs the diagnostic performance of cardiac natriuretic peptides in dyspneic patients:results from the BACH Study(Biomarkers in ACute Heart Failure)[J].JACC Heart Fail,2013,1(3):192-199 [2] Takase H,Dohi Y,Sonoda H,et al.Prediction of Atrial Fibrillation by B-type Natriuretic Peptide[J].J Atr Fibrillation,2013,5(6):674. [3] Chua W,Purmah Y,Cardoso V R,et al.Data-driven discovery and validation of circulating blood-based biomarkers associated with prevalent atrial fibrillation[J].Eur Heart J,2019,40(16):1268-1276. [4] Yang Z,Xu M,Zhang C,et al.A predictive model using left atrial function and B-type natriuretic peptide level in predicting the recurrence of early persistent atrial fibrillation after radiofrequency ablation[J].Clin Cardiol,2021,44(3):407-414. [5] Svennberg E,Lindahl B,Berglund L,et al.NT-proBNP is a powerful predictor for incident atrial fibrillation-Validation of a multimarker approach[J].Int J Cardiol,2016,223:74-81. [6] Zhao X,Li H,Liu C,et al.NT Pro-BNP can be used as a risk predictor of clinical atrial fibrillation with or without left atrial enlargement[J].Clin Cardiol,2022,45(1):68-74. [7] Berntsson J,Smith J G,Nilsson P M,et al.Pro-atrial natriuretic peptide and prediction of atrial fibrillation and stroke:The MalmöPreventive Project[J].Eur J Prev Cardiol,2017,24(8):788-795. [8] Karolina I,MichałK,Marzenna Z.MR-proANP level predicts new onset atrial fibrillation in patients with acute myocardial infarction[J].Biomarkers,2020,25(7):573-577. [9] Tilea I,Varga A,Serban R C.Past,Present,and Future of Blood Biomarkers for the Diagnosis of Acute Myocardial Infarction-Promises and Challenges[J].Diagnostics(Basel),2021,11(5). [10] Paana T,Jaakkola S,Biancari F,et al.Minor troponin T elevation and mortality in patients with atrial fibrillation presenting to the emergency department[J].Eur J Clin Invest,2021,51(11):e13590. [11] Scott L,Jr.,Li N,Dobrev D.Role of inflammatory signaling in atrial fibrillation[J].Int J Cardiol,2019,287:195-200. [12] Wang Z,Wang B,Li X,et al.Metabolic syndrome,high-sensitivity C-reactive protein levels and the risk of new-onset atrial fibrillation:Results from the Kailuan Study[J].Nutr Metab Cardiovasc Dis,2021,31(1):102-109. [13] Xie J Y,Noeman M,Pimenta D,et al.C-reactive protein as a predictor for developing post-operative atrial fibrillation[J].Europace, 2021,23(1):159. [14] Li X,Peng S,Wu X,et al.C-reactive protein and atrial fibrillation:Insights from epidemiological and Mendelian randomization studies[J].Nutr Metab Cardiovasc Dis,2022,32(6):1519-1527. [15] Yang X,Zhao S,Wang S,et al.Systemic inflammation indicators and risk of incident arrhythmias in 478,524 individuals:evidence from the UK Biobank cohort[J].BMC Med,2023,21(1):76. [16] Lazzerini P E,Acampa M,Capecchi P L,et al.Antiarrhythmic potential of anticytokine therapy in rheumatoid arthritis:tocilizumab reduces corrected QT interval by controlling systemic inflammation[J].Arthritis Care Res(Hoboken),2015,67(3):332-339. [17] Shen H,Wang J,Min J,et al.Activation of TGF-β1/α-SMA/Col I Profibrotic Pathway in Fibroblasts by Galectin-3 Contributes to Atrial Fibrosis in Experimental Models and Patients[J].Cell Physiol Biochem,2018,47(2):851-863. [18] López B,González A,Querejeta R,et al.Galectin-3 and histological,molecular and biochemical aspects of myocardial fibrosis in heart failure of hypertensive origin[J].Eur J Heart Fail,2015,17(4):385-392. [19] Cheng W L,Chen Y C,Li S J,et al.Galectin-3 enhances atrial remodelling and arrhythmogenesis through CD98 signalling[J].Acta Physiol(Oxf),2022,234(3):e13784 [20] Hu X F,Zhan R,Xu S,et al.Growth differentiation factor 15 is associated with left atrial/left atrial appendage thrombus in patients with nonvalvular atrial fibrillation[J].Clin Cardiol,2018,41(1):34-38. [21] May B M,Pimentel M,Zimerman L I,et al.GDF-15 as a Biomarker in Cardiovascular Disease[J].Arq Bras Cardiol,2021,116(3):494-500. [22] Hijazi Z,Oldgren J,Siegbahn A,et al.Application of Biomarkers for Risk Stratification in Patients with Atrial Fibrillation[J].Clin Chem,2017,63(1):152-164. [23] Zhou J,Kang Z,Liu L,et al.Predicting Value of Growth Differentiation Factor 15 and Its Correlations With Atrial Fibrillation[J].Heart Surg Forum,2020,23(4):E452-e460. [24] Aleksova A,Paldino A,Beltrami A P,et al.Cardiac Biomarkers in the Emergency Department:The Role of Soluble ST2(sST2)in Acute Heart Failure and Acute Coronary Syndrome-There is Meat on the Bone[J].J Clin Med,2019,8(2):270. [25] Song Y,Li F,Xu Y,et al.Prognostic value of sST2 in patients with heart failure with reduced,mid-range and preserved ejection fraction[J].Int J Cardiol,2020,304:95-100. [26] Ma X,Yuan H,Luan H X,et al.Elevated soluble ST2 concentration may involve in the progression of atrial fibrillation[J].Clin Chim Acta,2018,480:138-142. [27] Wałek P,Gorczyca I,Grabowska U,et al.The prognostic value of soluble suppression of tumourigenicity 2 and galectin-3 for sinus rhythm maintenance after cardioversion due to persistent atrial fibrillation in patients with normal left ventricular systolic function[J].Europace,2020,22(10):1470-1479. [28] Li J.The Role of Autoantibodies in Arrhythmogenesis[J].Curr Cardiol Rep,2020,23(1):3. [29] Fairfax A,Doniach D.Autoantibodies to cardiac conducting tissue and their characterization by immunofluorescence[J].Clin Exp Immunol,1976,23(1):1-8. [30] Saxena A,Izmirly P M,Mendez B,et al.Prevention and treatment in utero of autoimmune-associated congenital heart block[J].Cardiol Rev,2014,22(6):263-267. [31] Lazzerini P E,Murthy Ginjupalli V K,Srivastava U,et al.Anti-Ro/SSA Antibodies Blocking Calcium Channels as a Potentially Reversible Cause of Atrioventricular Block in Adults[J].JACC Clin Electrophysiol,2023,9(8 Pt 3):1631-1648. [32] Lazzerini,Pietro Enea,et al."Anti-Ro/SSA antibodies and the autoimmune long-QT syndrome."Frontiers in Medicine 8(2021):730161.

点击下载PDF