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Distribution of circulating cardiac biomarkers in healthy children: from birth through adulthood
Chiara Caselli1, Rosetta Ragusa2, Concetta Prontera3
1CNR, Institute of Clinical Physiology, Pisa, Italy.
Insights
Cardiac biomarkers like N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hs-cTnI) are highest in newborns and decrease with age. These findings support developing pediatric reference intervals for these key cardiac markers.
Area of Science:
- Pediatric Cardiology
- Biomarker Research
- Clinical Diagnostics
Background:
- Circulating biomarkers are vital for adult cardiovascular care.
- Their role and typical values in healthy children remain largely uncharacterized.
Purpose of the Study:
- To evaluate plasma concentrations of key cardiac biomarkers in healthy children across different age groups.
- To establish baseline levels of NT-proBNP, hs-cTnI, sST2, and Galectin-3 in pediatric populations.
Main Methods:
- Assessed plasma levels of NT-proBNP, hs-cTnI, sST2, and Galectin-3 in 106 healthy children.
- Divided subjects into newborns, infants, children, and adolescents.
- Included healthy adults as controls for comparison.
Main Results:
- NT-proBNP and hs-cTnI levels were significantly highest in newborns and decreased with age (p < 0.001).
- Soluble ST2 (sST2) and Galectin-3 showed no significant age-related differences.
- Observed distinct patterns for NT-proBNP and hs-cTnI across pediatric age strata.
Conclusions:
- Age-dependent changes in hs-cTnI and NT-proBNP indicate the need for specific pediatric reference intervals.
- Further research in larger cohorts is recommended to establish robust age- and sex-based reference ranges for these biomarkers.
Aim:
While circulating biomarkers are critical tools for cardiovascular adult care, their relevance in childhood is unknown.
Methods:
We evaluated the behavior of plasma concentrations of clinically relevant cardiac biomarkers (NT-proBNP, hs-cTnI, sST2, Galectin-3) in 106 healthy children.
Results:
Subjects were divided into age subgroups: 24 newborns (0-30 days), 26 infants (1-12 months), 30 children (1-12 years) and 26 adolescents (13-18 years). Healthy adults were used as control. NT-proBNP (newborns: 504.3 [211.07-942.7] ng/L, median [25-75 percentiles]; infants: 200.64 [76.88-306.73]; children: 97.27 [49.24-271.80]; adolescents: 24.35 [13.14-58.83]; p < 0.001) and hs-cTnI (newborns: 9.3 [3.3-93.8] ng/L; infants: 13.8 [4.82-72.52]; children: 11.45 [4.0-48.10]; adolescents: 2.6[2.07-3.90]; p < 0.001) were highest in the first month of life, showing a decline in the next years. sST2 and Galectin-3 showed no differences.
Conclusion:
Changes in hs-cTnI and NT-proBNP suggest the design of age- and sex-based reference intervals that will have to be explored in a larger population.
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