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Molecular signature of cardiogenic shock
Oriol Iborra-Egea1,2, Ferran Rueda1,2, Cosme García-García1,2
1Department of Cardiology, Heart Institute, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n 08916, Barcelona, Spain.
Insights
Cardiogenic shock (CS) is a complex condition with high mortality. New molecular biomarkers, like the CS4P score, show promise for improved diagnosis and treatment of this critical illness.
Area of Science:
- Biochemistry
- Cardiology
- Molecular Biology
Background:
- Cardiogenic shock (CS) incidence is rising, posing significant clinical challenges with high mortality rates.
- CS involves cardiac dysfunction, multiorgan failure, and systemic inflammation with metabolic disruption.
Purpose of the Study:
- To review biochemical markers in CS, including established and novel candidates.
- To discuss the potential of advanced -omics data for a comprehensive molecular signature of CS.
Main Methods:
- Review of existing literature on CS biomarkers.
- Analysis of novel genomic, transcriptomic, and proteomic data.
- Detailed description of the CS4P molecular score (liver fatty acid-binding protein, beta-2-microglobulin, fructose-bisphosphate aldolase B, SerpinG1).
Main Results:
- Current clinical practice relies on glucose and lactate as primary biomarkers.
- Novel proteomic signatures, such as the CS4P score, offer a more holistic view of CS.
- -Omics technologies are revealing deeper molecular insights into CS pathophysiology.
Conclusions:
- Existing biomarkers for CS are limited.
- Emerging molecular signatures and scores like CS4P represent a significant advancement in understanding CS.
- New diagnostic and therapeutic strategies are needed to improve patient outcomes in CS.
Abstract:
The incidence of cardiogenic shock (CS) has increased remarkably over the past decade and remains a challenging condition with mortality rates of ∼50%. Cardiogenic shock encompasses cardiac contractile dysfunction; however, it is also a multiorgan dysfunction syndrome, often complicated by a systemic inflammatory response with severe cellular and metabolic dysregulations. Here, we review the evidence on the biochemical manifestations of CS, elaborating on current gold standard biomarkers and novel candidates from molecular signatures of CS. Glucose and lactate, both identified over a century ago, remain the only clinically used biomarkers in current predictive risk scores. Novel genomic, transcriptomic, and proteomic data are discussed, and a recently reported molecular score derived from unbiased proteomic discovery, the CS4P, which includes liver fatty acid-binding protein, beta-2-microglobulin, fructose-bisphosphate aldolase B, and SerpinG1 is comprehensively described. Recent advances in -omics technologies provide new insight into a more holistic molecular signature of CS. Thus, we need to open new diagnostic and therapeutic avenues if we aim to improve outcomes.
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