Bruno Caracci, Carolyne Pehora, Lee Benson, Benjamin E. Steinberg, Neil M. Goldenberg, Katherine Taylor
Hospital for Sick Children and University of Toronto.
Canada
Journal of Cardiothoracic and Vascular Anesthesiology
J Cardiothorac Vasc Anesthesiol 2024;
DOI: 10.1053/j.jvca.2024.07.020
Abstract
Objectives: Pulmonary arterial hypertension (PAH) is a devastating complication of pediatric congenital heart disease (CHD). A recent study has identified the protein high mobility group box-1 (HMGB1) as a diagnostic tool in adults with CHD-associated PAH. HMGB1 levels in adults with CHD-associated PAH correlated with mean pulmonary artery pressure and pulmonary vascular resistance, and HGMB1 levels fell in response to sildenafil therapy. We wanted to assess if HGMB1 was a biomarker of pediatric CHD-PAH.
Design: Prospective cohort study.
Setting: Quaternary pediatric academic hospital PARTICIPANTS: Children ≤18 years with CHD with and without known pulmonary hypertension. Controls were children undergoing dental or urologic surgery with no known heart disease.
Interventions: Pulmonary hemodynamics, echocardiographic assessment, and biomarker measurement. Controls had biomarker measurement only.
Measurements and main results: Patients with CHD-PAH had mean pulmonary vascular resistance index of 10 Wood units/m2. Neither HGMB1 nor N-terminal pro-brain-type natriuretic peptide levels were significantly different between the groups. Neither marker correlated with pulmonary hypertension.
Conclusions: Unlike in adults, HGMB1 is not a biomarker of PAH in pediatric CHD. Further work will continue to explore for biomarkers for this high-risk population.
Category
Class I. Pulmonary Hypertension Associated with Congenital Cardiovascular Disease
Potential Biomarkers Associated with Pulmonary Vascular Disease
Diagnostic Testing for Pulmonary Vascular Disease. Invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
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