PROGNOSTIC BIOMARKERS IN CONGENITAL HEART DISEASE

Authors:

Abstract:

This study aimed to assess the diagnostic significance of N-terminal pro-B-type natriuretic peptide in detecting and evaluating disease severity in infants less than one year of age with congenital heart disease. Results showed, that N-terminal pro-B-type natriuretic peptide levels in critically ill infants with congenital heart anomalies were approximately 10 times higher than in healthy infants (p<0.001). However, the difference in N-terminal pro-B-type natriuretic peptide levels between survivors and non-survivors were not statistically significant, though there was a notable high deviation in the non-survivors group. We observed a statistically significant increase in lactate levels in the deceased group compared to survivors, with a positive correlation between lactate and N-terminal pro-B-type natriuretic peptide levels (rho=0.333; p=0.003). These findings highlight the importance of monitoring both N-terminal pro-B-type natriuretic peptide and lactate levels as key biomarkers for predicting outcomes in critically ill infants.

Keywords:

congenital heart anomalies NT-proBNP lactate mortality risk indicator infants

References:

1. Abbas A, Ewer AK. New born pulse oximetry screening: A global perspective. Early Hum Dev. 2021 Nov; 162:105457. doi: 10.1016/j.earlhumdev.2021.105457.
2. Bakker J, Postelnicu R, Mukherjee V. Lactate: Where Are We Now? Crit Care Clin. 2020 Jan;36(1):115-124. doi: 10.1016/j.ccc.2019.08.009.
3. Cantinotti M, Walters HL, Crocetti M, Marotta M, Murzi B, Clerico A. BNP in children with congenital cardiac disease: is there now sufficient evidence for its routine use? Cardiol Young. 2015 Mar;25(3):424-37. doi: 10.1017/S1047951114002133.
4. Gafarov IA. Biostatistika [Biostatistics]. Bakı, Təbib, 2022, 240 s. ISBN: 978-9952-37-813-9. [in Azerbaijani]
5. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1736-1788. doi: 10.1016/S0140-6736(18)32203-7.
6. Harris SL, More K, Dixon B, Troughton R, Pemberton C, Horwood J, et al. Factors affecting N-terminal pro-B-type natriuretic peptide levels in preterm infants and use in determination of haemodynamic significance of patent ductus arteriosus. Eur J Pediatr. 2018 Apr;177(4):521-532. doi: 10.1007/s00431-018-3089-y.
7. Hauser JA, Demyanets S, Rusai K, Goritschan C, Weber M, Panesar D, et al. Diagnostic performance and reference values of novel biomarkers of paediatric heart failure. Heart. 2016 Oct 15;102(20):1633-9. doi: 10.1136/heartjnl-2016-309460.
8. Kiess A, Green J, Willenberg A, Ceglarek U, Dähnert I, Jurkutat A, et al. Age-Dependent Reference Values for hs-Troponin T and NT-proBNP and Determining Factors in a Cohort of Healthy Children (The LIFE Child Study). Pediatr Cardiol. 2022 Jun;43(5):1071-1083. doi: 10.1007/s00246-022-02827-x.
9. Lin Z, Chen Y, Zhou L, Chen S, Xia H. Serum N-Terminal Pro-B-Type Natriuretic Peptide as a Biomarker of Critical Pulmonary Stenosis in Neonates. Front Pediatr. 2022 Jan 5;9:788715. doi: 10.3389/fped.2021.788715.
10. Liu Y, Chen S, Zühlke L, Black GC, Choy MK, Li N, et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. 2019 Apr 1;48(2):455-463. doi: 10.1093/ije/dyz009.
11. Plana MN, Zamora J, Suresh G, Fernandez-Pineda L, Thangaratinam S, Ewer AK. Pulse oximetry screening for critical congenital heart defects. Cochrane Database Syst Rev. 2018 Mar 1;3(3):CD011912. doi: 10.1002/14651858.CD011912.pub2.
12. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, et al; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016 Jul 14;37(27):2129-2200. doi: 10.1093/eurheartj/ehw128.
13. Shevchenko TI, Shaposhnyk OA, Sorokina SI, Kudrya IP, Efremenko VM. Peculiarities of management of patients with late-diagnosed congenital heart disease. World of Medicine and Biology. 2019. 1 (67). 111–116. DOI 10.26724/2079-8334-2019-1-67-111
14. Sülü A, Kıztanır H, Kosger P, Ucar B. Relationship of Pro-BNP Levels with Cardiovascular Events in Pediatric Cardiac and Non-cardiac Diseases. J Contemp Med. Mayıs 2023;13(3):549-554. doi:10.16899/jcm.1279791.
15. Zhou S, Liu L, Jin X, Dorikun D, Ma S. Biomarkers predicting postoperative adverse outcomes in children with congenital heart disease: a systematic review and meta-analysis. Front Pediatr. 2025 Jan 17;13:1508329. doi: 10.3389/fped.2025.1508329.

Publication:

«World of Medicine and Biology» Vol. 21 No. 92 (2025) , с. 7-11
УДК 616.12–007.2–053.1–089.168

DOI:

https://doi.org/10.26724/2079-8334-2025-2-92-7-11