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Heart failure biomarker levels correlate with invasive haemodynamics in pulmonary valve replacement

Published online by Cambridge University Press:  27 November 2019

Phillip M. Zegelbone Open the ORCID record for Phillip M. Zegelbone [Opens in a new window] ,
Richard E. Ringel ,
John D. Coulson ,
Melanie K. Nies ,
Meagan E. Stabler ,
Jeremiah R. Brown  and
Allen D. Everett
Phillip M. Zegelbone
Affiliation:
Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
Richard E. Ringel
Affiliation:
Division of Pediatric Cardiology, Johns Hopkins Children’s Center, Baltimore, MD, USA
John D. Coulson
Affiliation:
Division of Pediatric Cardiology, Johns Hopkins Children’s Center, Baltimore, MD, USA
Melanie K. Nies
Affiliation:
Division of Pediatric Cardiology, Johns Hopkins Children’s Center, Baltimore, MD, USA
Meagan E. Stabler
Affiliation:
Department of Epidemiology, Geisel School of Medicine, Lebanon, NH, USA
Jeremiah R. Brown
Affiliation:
Department for Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA
Allen D. Everett*
Affiliation:
Division of Pediatric Cardiology, Johns Hopkins Children’s Center, Baltimore, MD, USA
*
Author for correspondence: A. Everett, MD, Pediatric Cardiology, Johns Hopkins Children’s Center, 1800 Orleans Street, Baltimore, MD 21231, USA. Tel: +1 410 955 5987; Fax: +1 410 955 0897. E-mail: aeveret3@jhmi.edu
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Abstract

Background:

Although widely used in cardiology, relation of heart failure biomarkers to cardiac haemodynamics in patients with CHD (and in particular with pulmonary insufficiency undergoing pulmonary valve replacement) remains unclear. We hypothesised that the cardiac function biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP), soluble suppressor of tumorigenicity 2, and galectin-3 would have significant associations to right ventricular haemodynamic derangements.

Methods:

Consecutive patients ( n = 16) undergoing cardiac catheterisation for transcatheter pulmonary valve replacement were studied. NT-proBNP, soluble suppressor of tumorigenicity 2, and galectin-3 levels were measured using a multiplex enzyme-linked immunosorbent assay from a pre-intervention blood sample obtained after sheath placement. Spearman correlation was used to identify significant correlations (p ≤ 0.05) of biomarkers with baseline cardiac haemodynamics. Cardiac MRI data (indexed right ventricular and left ventricular end-diastolic volumes and ejection fraction) prior to device placement were also compared to biomarker levels.

Results:

NT-proBNP and soluble suppressor of tumorigenicity 2 were significantly correlated (p < 0.01) with baseline mean right atrial pressure and right ventricular end-diastolic pressure. Only NT-proBNP was significantly correlated with age. Galectin-3 did not have significant associations in this cohort. Cardiac MRI measures of right ventricular function and volume were not correlated to biomarker levels or right heart haemodynamics.

Conclusions:

NT-proBNP and soluble suppressor of tumorigenicity 2, biomarkers of myocardial strain, significantly correlated to invasive pressure haemodynamics in transcatheter pulmonary valve replacement patients. Serial determination of soluble suppressor of tumorigenicity 2, as it was not associated with age, may be superior to serial measurement of NT-proBNP as an indicator for timing of pulmonary valve replacement.

Keywords

Biomarkerpulmonary valvetetralogy of Fallot
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 1 , January 2020 , pp. 50 - 54
Copyright
© Cambridge University Press 2019

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