Biochemische Marker der Myokardschädigung bei ischämischer versus nicht ischämischer Ätiologie

Zusammenfassung

Biomarker sind objektiv gemessene Indikatoren physiologischer oder pathologischer biologischer Prozesse, die möglichst sensitiv, spezifisch, reproduzierbar und kosteneffektiv bestimmt werden sollten. Sie werden als Antwort auf akute myokardiale Ischämie, chronischen myokardialen Stress, Inflammation oder strukturelle Umbauprozesse freigesetzt. Die wichtigsten Biomarker in der klinischen Routine sind (hochsensitive) Troponine (akute Myokardischämie) und natriuretische Peptide (Druck-/Volumenbelastung). Strukturelle Marker (Fibrose/Remodeling) werden noch nicht routinemäßig eingesetzt.

Abstract

Biomarker are objectively measured indicators of physiological or pathological biological processes that, ideally, can be determined at high sensitivity, specificity, reproducibility and cost-effectiveness. They are secreted as response to acute myocardial ischemia, chronic myocardial stress, inflammation and structural remodelling. The most important biomarkers in clinical routine are high-sensitive cardiac troponins (acute myocardial ischemia) and natriuretic peptides (pressure/volume overload). Structural markers (fibrosis/remodelling) are not yet widely used in clinical routine.

Was ist wichtig?

• Troponin: konkurrenzlos in der Diagnostik der akuten Myokardischämie, Dynamik entscheidend.

• Natriuretische Peptide: sensitiver Nachweis von myokardialem Stress und damit Goldstandard in der Diagnostik der Herzinsuffizienz.

• Fibrosemarker: gute Korrelation mit myokardialem Remodeling, allerdings bisher ohne konkreten klinischen Einsatz.

Schlüsselwörter

Biomarker - Myokardischämie - Troponin - natriuretische Peptide - Myokardschaden - Remodeling

Key words

biomarkers - myocardial ischemia - troponin - natriuretic peptides - myocardial injury - remodeling

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