Новые биомаркеры легочной гипертензии

Легочная гипертензия (ЛГ) представляет собой клинический синдром, характеризующийся прогрессирующим повышением легочного сосудистого сопротивления, которое приводит к ремоделированию правого желудочка, его недостаточности и преждевременной смерти пациентов. Ранняя диагностика и мониторинг прогрессирования заболевания имеют решающее значение для принятия решений о необходимой терапии. «Золотым стандартом» диагностики ЛГ является катетеризация правых отделов сердца. Для мониторирования течения болезни используется оценка систолического давления в легочной артерии с помощью трансторакальной эхокардиографии. В дополнение к этому существует потребность в неинвазивных биомаркерах, отражающих патологические изменения в сосудах легочной артерии и позволяющих диагностировать ЛГ. В обзоре излагаются данные о таких биомаркерах, как срединный фрагмент проадреномедулина, карбоксиконцевой проэндотелин-1, копептин, асимметричный диметиларгинин, 15-й фактор роста и дифференциации роста, которые классифицируются на основе их зависимости от дисфункции эндотелиальных клеток, воспаления, эпигенетики, функции сердца, окислительного стресса, внеклеточного матрикса. Определение биомаркеров, имеющих диагностическую ценность для прогнозирования тяжести, прогрессирования ЛГ и ответа на терапию, в простом анализе крови или конденсате выдыхаемого воздуха, значительно может снизить затраты на лечение и улучшить ведение больных ЛГ.

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