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Associations between neurohormonal and inflammatory activation and heart failure in children

Christopher Ratnasamy1, Daniel D Kinnamon, Steven E Lipshultz

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, University of Miami/Jackson Memorial Medical Center, Miami, FL 33101, USA.

American Heart Journal
|February 26, 2008
PubMed

Insights

Neuroendocrine and inflammatory activation correlate with increased symptom severity and poorer cardiac function in pediatric heart failure (HF). Biomarker levels can help assess HF severity in children.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Biomarker Discovery

Background:

  • Adult heart failure (HF) is linked to neuroendocrine and inflammatory system activation.
  • The association between these systems and pediatric HF severity is not well-established.

Purpose of the Study:

  • To investigate the relationship between neuroendocrine/inflammatory activation and symptom severity in pediatric HF.
  • To explore correlations with echocardiographic measurements in pediatric HF patients.

Main Methods:

  • Nineteen pediatric HF patients were categorized into three symptom severity groups.
  • Echocardiographic parameters including left ventricular (LV) ejection fraction and Z scores were measured.
  • Blood levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), and tumor necrosis factor (TNF) alpha and receptor II were quantified.

Main Results:

  • Elevated NT-proBNP and hsCRP levels significantly correlated with increased symptom severity and differentiated clinical groups.
  • NT-proBNP showed negative associations with LV ejection fraction and positive associations with LV end-systolic diameter Z score.
  • TNF-alpha and hsCRP also demonstrated significant correlations with cardiac function and NT-proBNP levels.

Conclusions:

  • Neuroendocrine and inflammatory activation are associated with greater symptom severity and poorer cardiac characteristics in pediatric HF.
  • Measured biomarkers like NT-proBNP and hsCRP show potential for assessing HF severity in children.
Abstract

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