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Histological Quantification of Chronic Myocardial Infarct in Rats
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Reading the Signature of Autophagy in the Ischemic and Infarcted Heart: A Systematic Review of Circulating Biomarkers
Davide Radaelli1, Asma Alshaeb2, Ibrahim Al-Habash3
1Department of Medical Surgical and Health Sciences, Cattinara University Hospital, University of Trieste, Strada di Fiume, 34149 Trieste, Italy.
Insights
Autophagy biomarkers show promise for early detection of heart attacks. These markers, unlike traditional ones, reveal cellular changes during cardiac ischemia, improving diagnosis and patient outcomes.
Area of Science:
- Cardiology
- Cellular Biology
- Biomarker Discovery
Background:
- Ischemic heart disease is a leading global cause of mortality.
- Current cardiac biomarkers like troponin lack insight into early cellular events of myocardial infarction.
- Autophagy plays a crucial role in the pathophysiology of cardiac ischemia and reperfusion injury.
Purpose of the Study:
- To systematically review and identify autophagy-related biomarkers for cardiac ischemia and infarction.
- To explore the potential of these biomarkers for early diagnosis, prognosis, and therapeutic strategies.
- To enhance understanding of the molecular mechanisms underlying myocardial infarction.
Main Methods:
- A comprehensive literature search was conducted up to June 1, 2025.
- Included studies focused on autophagy biomarkers in human and animal models of cardiac ischemia/infarction.
- A total of 14 eligible articles were systematically reviewed.
Main Results:
- Thirteen autophagy-related biomarkers were identified: LC3-II/I, Beclin-1, ATG5, ATG7, p62, WIPI1, FGF21, CHRF, Rubicon, IL-1β, IL-18, and adiponectin.
- These biomarkers demonstrated dynamic, time-dependent changes during myocardial infarction stages.
- Autophagy biomarkers offer insights into the early molecular mechanisms of cardiac ischemia.
Conclusions:
- Autophagy biomarkers represent a significant advancement in understanding early myocardial ischemia and infarction.
- Integrating autophagy biomarkers with traditional markers can improve risk stratification and treatment decisions.
- These novel biomarkers hold potential for enhanced prognosis in patients with ischemic heart disease.
Abstract:
Ischemic heart disease is the main cause of death worldwide. Classic cardiac biomarkers, such as troponin, which are released due to myocyte necrosis, are widely used for diagnosis, but they provide limited information about the initial underlying cellular processes involved in myocardial infarction. Autophagy is now considered fundamental in the pathophysiology of cardiac ischemia and related reperfusion injury. This systematic review aims to identify and highlight candidate autophagy-related biomarkers in cardiac ischemia and infarction with potential benefits for early diagnosis, prognosis, and therapy. A comprehensive literature search was conducted up to 1 June 2025. We included studies that examined biomarkers involved in the autophagy process in cardiac ischemia/infarction, which involved humans and animal models. A total of 14 eligible articles were reviewed. Thirteen autophagy-related biomarkers were identified, including LC3-II/I, Beclin-1, ATG5, ATG7, p62, WIPI1, FGF21, CHRF, Rubicon, IL-1β, IL-18, and adiponectin. These biomarkers have a dynamic pattern, and they exhibited time-dependent changes during the different stages of myocardial infarction. Autophagy biomarkers present a promising understanding of the molecular mechanism of early myocardial ischemia and infarction. Integration of autophagy biomarkers with the classic markers should improve risk stratification, therapeutic decision-making, and prognosis in patients with ischemic heart disease.
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