Fluid-based assays and precision medicine of cardiovascular diseases: the 'hope' for Pandora's box?

摘要: Progresses in liquid-based assays may provide novel useful non-invasive indicators of cardiovascular (CV) diseases. By analysing circulating cells or their products blood, saliva and urine samples, we can investigate molecular changes present at specific time points each patient allowing sequential monitoring disease evolution. For example, an increased number endothelial be a diagnostic biomarker for diabetic nephropathy heart failure with preserved ejection fraction. The assessment cell-free DNA (cfDNA) levels to predict severity acute myocardial infarction, as well diagnose graft rejection. Remarkably, epigenetic biomarkers, including methylation, histone modifications non-coding RNAs are key pathogenic determinants CV diseases representing putative biomarkers drug targets. the unmethylated FAM101A gene specifically trace cfDNA derived from cardiomyocyte death providing powerful apoptosis during ischaemia. Moreover, plasma miR-92 coronary syndrome onset patients diabetes. Now, network medicine provides framework analyse huge amount big data by describing result chain perturbations rather than single defect (reductionism). We outline advantages challenges liquid biopsy respect traditional tissue summarise main completed ongoing clinical trials Furthermore, discuss importance combining fluid-based assays, improve precision personalised therapy this field.