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Multisystem inflammatory syndrome in children: Inputs of BNP, NT-proBNP and Galectin-3

Alexandre Raynor1, Clarisse Vallée1, Anne-Laure Belkarfa1

  • 1Service de Biochimie Générale, AP-HP, Hôpital Universitaire Necker-Enfants malades, Paris, France.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|February 20, 2022
PubMed

Insights

NT-proBNP may be a more sensitive biomarker than BNP for early detection of heart failure in children with Multisystem Inflammatory Syndrome in Children (MIS-C). Galectin-3 levels were unaffected in MIS-C patients.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Biomarker Research

Background:

  • Multisystem Inflammatory Syndrome in Children (MIS-C) is a post-COVID-19 condition affecting children.
  • Cardiac involvement, including dysfunction and shock, occurs in 80-85% of MIS-C patients.
  • Early identification of cardiac involvement is crucial for effective management.

Purpose of the Study:

  • To compare the utility of three cardiac biomarkers: BNP, NT-proBNP, and Galectin-3.
  • To assess these biomarkers in a cohort of French children hospitalized with MIS-C and cardiac involvement.
  • To determine the most sensitive biomarker for detecting heart failure in MIS-C.

Main Methods:

  • A cohort of 14 hospitalized children with MIS-C and cardiac involvement (confirmed by echocardiography) was studied.
  • SARS-CoV-2 serology was positive in all participants.
  • BNP, NT-proBNP, and Galectin-3 levels were measured at admission, discharge, and follow-up.

Main Results:

  • Galectin-3 levels remained within the reference range and did not change significantly throughout the study period.
  • Both BNP and NT-proBNP were elevated in children with cardiogenic shock compared to those without.
  • NT-proBNP levels exceeded the positive predictive value for heart failure in both groups, while BNP levels were below the negative predictive value in children without cardiogenic shock but with cardiac dysfunction.

Conclusions:

  • Galectin-3 does not appear to be a reliable biomarker for MIS-C-related cardiac issues.
  • NT-proBNP shows potential as a more sensitive and earlier indicator of heart failure in MIS-C compared to BNP.
  • NT-proBNP may be a valuable tool for screening heart failure in pediatric MIS-C patients.
Abstract

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