Document Detail

Usefulness of various plasma biomarkers for diagnosis of heart failure in children with single ventricle physiology.
MedLine Citation:
PMID:  19840577     Owner:  NLM     Status:  MEDLINE    
Children with single ventricle physiology have increased ventricular work and are at greater risk of developing heart failure than other children with congenital heart disease. However, the diagnosis of heart failure is difficult because few objective measures have been validated for this cohort. Plasma proteins have been identified as biomarkers of heart failure in adults with structurally normal hearts. However, whether these correlate similarly with heart failure in children with single ventricle physiology is unknown, because the etiology of adult heart failure is typically ischemic heart disease, but heart failure in these children is presumed to be due to primary myocardial dysfunction. We conducted a single-site, cross-sectional observational study of young, single-ventricle patients. Clinical heart failure was defined as a Ross score >2. The association of several candidate biomarkers with heart failure was assessed using logistic regression analysis and receiver operating characteristic curves. Of the 29 included children, 9 (31%) were in clinical heart failure. A doubling of plasma B-type natriuretic peptide was associated with an odds ratio for heart failure of 2.17. The area under the receiver operating characteristic curve was 80.3%. A threshold value of > or =30 pg/ml showed both sensitivity and specificity for heart failure. Three other candidate biomarkers were not associated with clinical heart failure in this sample. In conclusion, plasma B-type natriuretic peptide is a sensitive biomarker for clinical heart failure in young children with single-ventricle heart disease. The use of this plasma biomarker might facilitate detection of heart failure in these complex patients.
Amee Shah; Angela M Feraco; Cynthia Harmon; Theresa Tacy; Jeffrey R Fineman; Harold S Bernstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2009-11-24     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1280-4     Citation Subset:  AIM; IM    
Cardiovascular Research Institute, University of California, San Francisco, USA.
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MeSH Terms
Biological Markers / blood
C-Reactive Protein / analysis
Child, Preschool
Cross-Sectional Studies
Endothelin-1 / blood
Heart Failure / blood*,  diagnosis*
Heart Ventricles / abnormalities*
Infant, Newborn
Logistic Models
Natriuretic Peptide, Brain / blood
ROC Curve
Sensitivity and Specificity
Troponin I / blood
Grant Support
Reg. No./Substance:
0/Biological Markers; 0/Endothelin-1; 0/Troponin I; 114471-18-0/Natriuretic Peptide, Brain; 9007-41-4/C-Reactive Protein

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