Biomarker and shear stress in secondary pediatric pulmonary hypertension

Area of Science:

• Pediatric Cardiology
• Pulmonary Hypertension Pathophysiology
• Biomarker Discovery

Background:

• Pulmonary hypertension (PH) involves endothelial dysfunction, tissue damage, inflammation, and microthrombosis.
• Congenital heart diseases, specifically left-to-right shunts, can lead to PH.
• Identifying early indicators of PH in children is crucial for timely intervention.

Purpose of the Study:

• To investigate alterations in markers of endothelial dysfunction, tissue damage, inflammation, and microthrombosis in children with congenital left-to-right shunting.
• To identify specific indicators that can predict the development of PH in this pediatric population.
• To evaluate the diagnostic performance of selected biomarkers for PH.

Main Methods:

• A retrospective review of 25 children with PH due to congenital left-to-right shunts, 40 post-surgery patients, and 40 healthy controls.
• Measurement of serum brain natriuretic peptide (BNP), C-reactive protein (CRP), CA-125, and assessment of shear stress.
• Statistical analysis to determine significant differences and diagnostic accuracy (sensitivity, specificity) of biomarkers.

Main Results:

• Children with PH exhibited significantly increased serum BNP, CRP, and CA-125 levels.
• A significant decrease in shear stress was observed in children with PH.
• High sensitivity and specificity were reported for BNP (>225 pg/mL), CRP (>2.2 IU/L), CA-125 (>35 IU/mL), and shear stress (<2.5 dyn/cm2) in predicting PH.

Conclusions:

• BNP, CRP, CA-125, and shear stress are significantly altered in children with PH and congenital left-to-right shunting.
• These markers demonstrate high diagnostic accuracy for PH in the studied pediatric cohort.
• A combination of these biomarkers may serve as a valuable tool for predicting PH development during follow-up of children with congenital left-to-right shunts.