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Association between cardiac biomarkers and LVEF after congenital heart disease surgery in infants
Yuxiao Mo1, Qing Feng1, Xia Wang1
1Department of Pediatrics, Women and Children's Hospital, Zhongnan Hospital, Wuhan University, Wuhan, China.
Insights
Cardiac biomarkers like high-sensitivity troponin I (hs-TnI) and creatine kinase-MB (CK-MB) help assess myocardial injury after congenital heart disease (CHD) surgery in young children. Their peak levels predict cardiac function and complications.
Area of Science:
- Pediatric Cardiology
- Cardiac Surgery
- Biomarker Research
Background:
- Cardiac biomarkers are crucial for evaluating postoperative myocardial injury.
- Limited pediatric studies exist on the relationship between cardiac biomarkers and function post-surgery.
- Congenital heart disease (CHD) surgery in infants requires careful monitoring of cardiac status.
Purpose of the Study:
- To characterize dynamic changes in cardiac biomarkers after CHD surgery in pediatric patients (0-3 years).
- To assess the correlation between these biomarkers and cardiac function (LVEF).
- To evaluate the predictive accuracy of biomarkers for cardiac dysfunction, complications, and mortality.
Main Methods:
- Retrospective enrollment of 63 pediatric patients (0-3 years) undergoing CHD surgery.
- Measurement of cardiac biomarkers and left ventricular ejection fraction (LVEF) preoperatively and within 1 week postoperatively.
- Analysis of associations between biomarkers and LVEF, using ROC curves for predictive accuracy.
Main Results:
- Biomarker levels peaked on postoperative day 1, declining within a week.
- LVEF showed initial decrease, recovering by postoperative days 4-7.
- Peak hs-TnI and CK-MB levels correlated negatively with LVEF on postoperative day 1.
- hs-TnI and CK-MB demonstrated good predictive power for cardiac dysfunction and complications, but limited value for early mortality.
Conclusions:
- Hs-TnI and CK-MB are key biomarkers reflecting myocardial injury and cardiac function recovery post-CHD surgery in pediatric patients.
- Peak postoperative levels of hs-TnI and CK-MB can predict cardiac function recovery and composite complications.
- These findings aid in monitoring and managing pediatric patients after CHD surgery.
Objective:
Cardiac biomarkers are widely used to evaluate postoperative myocardial injury, but studies on their relationship with cardiac function in pediatrics are limited. This study aimed to characterize the dynamic changes of cardiac biomarkers after congenital heart disease (CHD) surgery in patients aged 0-3 years and assess their correlation with cardiac function.
Methods:
We retrospectively enrolled 63 pediatric patients (0-3 years) who underwent CHD surgery at Zhongnan Hospital between January 2021 and June 2024. Biomarkers and left ventricular ejection fraction (LVEF) were measured preoperatively and postoperatively within 1 week. The associations between the biomarkers and LVEF were analyzed. Receiver operating characteristic (ROC) curves were used to assess the predictive accuracy of the biomarkers for cardiac dysfunction, composite complications, and early mortality.
Results:
Biomarker levels peaked on postoperative day (POD) 1 and declined to near-baseline levels within 1 week. LVEF decreased initially and then gradually recovered to near preoperative levels by POD 4-7. LVEF on POD 1 negatively correlated with the peak high-sensitivity troponin I (hs-TnI) and creatine kinase-MB (CK-MB) levels. The ROC analysis showed that hs-TnI and CK-MB had good predictive power for cardiac dysfunction (AUC = 0.818 and 0.828) and composite complications (AUC = 0.736 and 0.745), but limited value for early mortality (AUC = 0.665).
Conclusion:
Hs-TnI and CK-MB are key biomarkers that reflect the relationship between myocardial injury and cardiac function recovery after CHD surgery in pediatric patients aged 0-3 years. Their peak postoperative levels can predict cardiac function recovery and composite complications.
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