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Biomarker und Vorhofflimmern

Vorhersage von Rezidiven und thromboembolischen Ereignissen nach rhythmuserhaltender Therapie
  • Jelena Kornej
  • Katja Schumacher
  • Daniela Husser
  • Gerhard Hindricks
Übersichten

Zusammenfassung

Vorhofflimmern (VHF) ist die häufigste Arrhythmie im klinischen Alltag und ist mit elektrischem und strukturellem atrialen Remodeling assoziiert. Obwohl die Katheterablation eine der wichtigsten nichtmedikamentösen Therapiestrategien bei VHF-Patienten ist, treten VHF-Rezidive relativ häufig auch nach mehreren Prozeduren auf. Leider sind klinische Komplikationen und Rhythmuserfolg nach der interventionellen Therapie nur eingeschränkt vorhersagbar, und neue therapeutische Konzepte – basierend auf individuellen Risikofaktoren – existieren (noch) nicht. Bisherige Versuche zur Verbesserung der diagnostischen Methoden führten jedoch zur Identifizierung diverser Biomarker, die eine wichtige Rolle in der Vorhersage von VHF-Entstehung, Progression und Rezidiven sowie assoziierten kardio- und zerebrovaskulären Ereignissen spielen. Der Begriff Biomarker bezieht sich im weitesten Sinne auf diverse biologische Marker, z. B. Proteine in Blut und Urin, aber auch auf Bildgebung usw. Anhand dieser Biomarker – z. B. im Blut (von-Willebrand-Faktor, D‑Dimer, natriuretische Peptide), Urin (Proteinurie, GFR), Bildgebung (Echokardiographie, CT oder MRT) – kann ein klinischer Score berechnet werden, um Hochrisikopatienten zu identifizieren und klinisch relevante Ereignisse vorherzusagen. Die wichtigste Zielsetzung dieser Übersichtsarbeit ist es, die Rolle von unterschiedlichen Biomarkern und deren Prädiktionskraft für wichtige VHF-assoziierte Ereignisse zu diskutieren.

Schlüsselwörter

Vorhofflimmern Katheterablation Kardioversion Rezidive Biomarker 

Biomarkers and atrial fibrillation

Prediction of recurrences and thromboembolic events after rhythm control management

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in clinical praxis and is associated with an increased risk for cardio- and cerebrovascular complications leading to an increased mortality. Catheter ablation represents one of the most important and efficient therapy strategies in AF patients. Nevertheless, the high incidence of arrhythmia recurrences after catheter ablation leads to repeated procedures and higher treatment costs. Recently, several scores had been developed to predict rhythm outcomes after catheter ablation. Biomarker research is also of enormous interest. There are many clinical and blood biomarkers pathophysiologically associated with AF occurrence, progression and recurrences. These biomarkers—including different markers in blood (e. g. von Willebrand factor, D‑dimer, natriuretic peptides) or urine (proteins, epidermal grown factor receptor) but also cardiac imaging (echocardiography, computed tomography, magnetic resonance imaging)—could help to improve clinical scores and be useful for individualized AF management and optimized patients’ selection for different AF treatment strategies. In this review, the role of diverse biomarkers and their predictive value related to AF-associated complications are discussed.

Keywords

Atrial fibrillation Catheter ablation Cardioversion Recurrences Biomarkers 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Kornej, K. Schumacher, D. Husser und G. Hindricks geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Jelena Kornej
    • 1
  • Katja Schumacher
    • 1
  • Daniela Husser
    • 1
  • Gerhard Hindricks
    • 1
  1. 1.Abteilung für RhythmologieHerzzentrum Leipzig, HELIOS Kliniken GmbHLeipzigDeutschland

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