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Published on: November 18, 2018
Endostatin and ST2 are predictors of pulmonary hypertension disease course in infants
Megan Griffiths1, Jun Yang1, Allen D Everett1
1Division of Pediatric Cardiology, Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA.
Insights
New biomarkers, endostatin and ST2, show promise for diagnosing and assessing infant pulmonary hypertension (PH). These markers correlate with PH severity, potentially improving upon current clinical standards for infant lung disease.
Area of Science:
- Biomarkers and diagnostics
- Pediatric cardiology
- Pulmonary diseases
Background:
- Pulmonary hypertension (PH) is a frequent comorbidity in infants with cardiopulmonary conditions.
- Elevated endostatin levels are observed in neonates with lung disease.
- ST2 is a known heart failure biomarker associated with PH in adults.
Purpose of the Study:
- To investigate the utility of endostatin and ST2 as biomarkers for diagnosing and categorizing the severity of PH in infants.
- To compare the predictive value of these biomarkers against existing clinical standards.
Main Methods:
- Plasma concentrations of endostatin, ST2, and NT-proBNP were measured in infants with and without PH.
- Regression models were used to correlate biomarker levels with echocardiographic and clinical features over time.
Main Results:
- Endostatin and ST2 levels were significantly elevated in infants with PH compared to controls (p < 0.0001).
- Endostatin correlated with right ventricular dysfunction, septal flattening, and pericardial effusion.
- ST2 concentrations predicted right-to-left patent ductus arteriosus flow (p = 0.009).
- NT-proBNP showed no significant association with PH features.
Conclusions:
- Endostatin and ST2 concentrations are associated with echocardiographic indicators of severe PH in infants.
- These biomarkers may offer superior predictive capabilities for infant PH compared to current clinical assessments.
Introduction:
Pulmonary hypertension (PH) is a common comorbidity of cardiopulmonary disease. Endostatin, an inhibitor of angiogenesis, is elevated in neonates with lung disease. ST2 is a heart failure biomarker correlated with PH in adults. We hypothesized that these biomarkers may be useful in diagnosing PH and categorizing its severity in infants.
Methods:
Endostatin, ST2, and NT-proBNP plasma concentrations from 26 infants with PH and 21 control infants without PH were correlated with echocardiographic and clinical features using regression models over time.
Results:
Endostatin, ST2, and NT-proBNP concentrations were elevated in PH participants versus controls (p < 0.0001). Endostatin was associated with right ventricular dysfunction (p = 0.014), septal flattening (p = 0.047), and pericardial effusion (p < 0.0001). ST2 concentrations predicted right to left patent ductus arteriosus flow (p = 0.009). NT-proBNP was not associated with PH features.
Conclusions:
Endostatin and ST2 concentrations were associated with echocardiographic markers of worse PH in infants and may be better predictors than existing clinical standards.
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