超越心肌梗死：用于心力衰竭预后和远程监测的即时心脏肌钙蛋白生物传感器
Beyond myocardial infarction: Point-of-care cardiac troponin biosensors for heart failure prognosis and remote monitoring.
摘要(中文译文)
心力衰竭（HF）是一种长期性疾病，常导致反复就医并需要密切监测。心肌肌钙蛋白I（cTnI）和心肌肌钙蛋白T（cTnT）作为心肌梗死的标志物已广为人知，但在心力衰竭中，它们还可反映持续存在的心肌损伤、疾病进展和不良预后。本综述探讨了重复检测肌钙蛋白的临床价值，以及即时检测（PoCT）生物传感器的发展，以实现更快速、更可及的监测。内容涵盖电化学免疫传感器、基于适配体的传感器、电化学发光（ECL）系统、场效应晶体管（FET）器件，以及新兴的可穿戴和微流控平台。本综述还讨论了出院后随访、远程医疗，以及结合B型利钠肽（BNP）、N末端B型利钠肽原（NT-proBNP）、心电图（ECG）、肾功能、症状和可穿戴设备数据进行综合判读。人工智能（AI）可能有助于患者个体化趋势分析和早期风险预警。然而，仍存在重大挑战，包括低水平检测灵敏度、全血检测、检测方法差异、信号漂移、误报警以及在真实心力衰竭患者中验证有限。未来的进展需要可靠的设备、清晰的临床路径和基于结局的研究。
Abstract
Heart failure (HF) is a long-term condition that often causes repeated hospital visits and requires close monitoring. Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are widely known as markers of myocardial infarction, but in HF they can also show ongoing heart-muscle injury, disease progression, and poor prognosis. This review examines the clinical value of repeated troponin measurements and the development of point-of-care testing (PoCT) biosensors for faster and more accessible monitoring. It covers electrochemical immunosensors, aptamer-based sensors, electrochemiluminescence (ECL) systems, field-effect transistor (FET) devices, and emerging wearable and microfluidic platforms. The review also discusses post-discharge follow-up, remote care, and combined interpretation with B-type natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiogram (ECG), kidney function, symptoms, and wearable data. Artificial intelligence (AI) may support patient-specific trend analysis and early risk alerts. However, major challenges remain, including low-level sensitivity, whole-blood testing, assay differences, signal drift, false alarms, and limited validation in real HF patients. Future progress will require reliable devices, clear clinical pathways, and outcome-based studies.
如何引用
AMA
Naregalkar Akshay Rangnath, K Sankar, Puja S Agrawal, Hrushikesh Madhukar Panchabudhe, Neha S Ingole, Pratik K Agrawal, et al. Beyond myocardial infarction: Point-of-care cardiac troponin biosensors for heart failure prognosis and remote monitoring.. Bioelectrochemistry (Amsterdam, Netherlands). 2026; doi:10.1016/j.bioelechem.2026.109433.
APA
Naregalkar Akshay Rangnath, K Sankar, Puja S Agrawal, Hrushikesh Madhukar Panchabudhe, Neha S Ingole, Pratik K Agrawal, et al (2026). Beyond myocardial infarction: Point-of-care cardiac troponin biosensors for heart failure prognosis and remote monitoring.. Bioelectrochemistry (Amsterdam, Netherlands). https://doi.org/10.1016/j.bioelechem.2026.109433
GB/T 7714
Naregalkar Akshay Rangnath, K Sankar, Puja S Agrawal, Hrushikesh Madhukar Panchabudhe, Neha S Ingole, Pratik K Agrawal, et al. Beyond myocardial infarction: Point-of-care cardiac troponin biosensors for heart failure prognosis and remote monitoring.[J]. Bioelectrochemistry (Amsterdam, Netherlands), 2026 doi:10.1016/j.bioelechem.2026.109433.
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