Hostname: page-component-84c44f86f4-mzw5b Total loading time: 0 Render date: 2025-10-14T23:08:52.966Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical significance of N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I in paediatric patients with CHD and heart failure: a retrospective study

Published online by Cambridge University Press:  22 August 2025

Cheng Wu  and
Xiaomei Zhong Open the ORCID record for Xiaomei Zhong [Opens in a new window]
Cheng Wu
Affiliation:
Cardiac Vascular Surgery, Ganzhou People’s Hospital, Ganzhou, Jiangxi, China
Xiaomei Zhong*
Affiliation:
Pediatrics, Ganzhou People’s Hospital, Ganzhou, Jiangxi, China
*
Corresponding author: Xiaomei Zhong; Email: 15083760567@163.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Heart failure is the most common complication of congenital heart disease (CHD), characterized by high morbidity and mortality. Early recognition and intervention are crucial for improving outcomes in pediatric patients with CHD and heart failure. This study aimed to analyze the clinical value of N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I in pediatric patients with CHD and heart failure.

Methods:

Ninety-eight pediatric patients with CHD complicated by heart failure were included in the Case Group, and 61 pediatric patients with CHD were included in the Control Group. The Case Group was categorized into subgroups based on the cardiac function of patients: grade I (n = 35), grade II (n = 40), and grade III (n = 23). Left ventricular ejection fraction was collected from pediatric patients in the case group. The correlation of the cardiac functional indicators with N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I levels was assessed using Pearson correlation analysis.

Results:

The serum levels of N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I in pediatric patients at grade III of cardiac function were significantly elevated compared to those at grade II, and these levels in patients at grade II were higher than those at grade I (P < 0.05). The left ventricular ejection fraction of pediatric patients in the Case Group were markedly negatively correlated with N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I (r = − 0.6807, r = −0.3013, r = −0.5412, P < 0.0001).

Conclusions:

N-terminal pro-brain natriuretic peptide, adrenomedullin, and cardiac troponin I have a certain diagnostic value in determining concurrent heart failure in pediatric patients with CHD.

Keywords

CHDheart failureN-terminal pro-brain natriuretic peptideadrenomedullincardiac troponin Iclinical value

Information

Type
Original Article
Information
Cardiology in the Young , Volume 35 , Issue 8 , August 2025 , pp. 1676 - 1682
Copyright
© The Author(s), 2025. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Kelleher, ST, McMahon, CJ, James, A. Necrotizing enterocolitis in children with congenital heart disease: a literature review. Pediatr Cardiol 2021; 42: 1688–1699.CrossRefGoogle ScholarPubMed
Rohit, M, Rajan, P. Approach to cyanotic congenital heart disease in children. Indian J Pediatr 2020; 87: 372–380.CrossRefGoogle ScholarPubMed
Briggs, KB, Fraser, JD. Enteral access and fundoplication in children with congenital heart disease. Semin Pediatr Surg 2021; 30: 151040.CrossRefGoogle ScholarPubMed
Kerstein, JS, Klepper, CM, Finnan, EG, Mills, KI. Nutrition for critically ill children with congenital heart disease. Nutr Clin Pract 2023; 38 (suppl 2): S158–s173.CrossRefGoogle ScholarPubMed
Selamet Tierney, ES. The benefit of exercise in children with congenital heart disease. Curr Opin Pediatr 2020; 32: 626–632.CrossRefGoogle ScholarPubMed
Ryan, KR, Jones, MB, Allen, KY, et al. Neurodevelopmental outcomes among children with congenital heart disease: at-risk populations and modifiable risk factors. World J Pediatr Congenit Heart Surg 2019; 10: 750–758.CrossRefGoogle ScholarPubMed
Massey, SL, Weinerman, B, Naim, MY. Perioperative neuromonitoring in children with congenital heart disease. Neurocrit Care 2024; 40: 116–129.CrossRefGoogle ScholarPubMed
Ghaemmaghami, Z, Khajali, Z, Dalili, M, Fotovati, Z, Moradian, M, Sheikhfathollahi, M. Pubertal status of children with congenital heart disease. Cardiol Young 2022; 32: 574–578.CrossRefGoogle ScholarPubMed
Dahlawi, N, Milnes, LJ, Swallow, V. Behaviour and emotions of children and young people with congenital heart disease: a literature review. J Child Health Care 2020; 24: 317–332.CrossRefGoogle Scholar
Taylor, D, Habre, W. Risk associated with anesthesia for noncardiac surgery in children with congenital heart disease. Paediatr Anaesth 2019; 29: 426–434.CrossRefGoogle ScholarPubMed
Newland, DM, Law, YM, Albers, EL, et al. Early clinical experience with dapagliflozin in children with heart failure. Pediatr Cardiol 2023; 44: 146–152.CrossRefGoogle ScholarPubMed
Billotte, M, Deken, V, Joriot, S, et al. Screening for neurodevelopmental disorders in children with congenital heart disease. Eur J Pediatr 2021; 180: 1157–1167.CrossRefGoogle ScholarPubMed
The Subspecialty Group of Cardiology; the Society of Pediatrics; Chinese Medical Association, Pediatric Cardiovascular Disease Committee; College of Cardiovascular Physicians; Chinese Medical Doctor Association and Pediatrics. tEBCJo. [Recommendations for diagnosis and treatment of heart failure in children (2020 revised edition)]. Zhonghua Er Ke Za Zhi 2021; 59: 84–94.Google Scholar
Das, BB, Frank, B, Ivy, D. Segmental pulmonary hypertension in children with congenital heart disease. Medicina (Kaunas) 2020; 56: 492.CrossRefGoogle ScholarPubMed
Newman, B. Airway abnormalities associated with congenital heart disease. Pediatr Radiol 2022; 52: 1849–1861.CrossRefGoogle ScholarPubMed
Shibata, T, Kondo, M, Fukushima, Y, et al. Epilepsy in children with congenital heart disease: risk factors and characteristic presentations. Pediatr Neurol 2023; 147: 28–35.CrossRefGoogle ScholarPubMed
Pesonen, E, Liuba, P, Aburawi, EH. Review findings included diminished coronary flow reserve after surgery in children with congenital heart disease and inflammation. Acta Paediatr 2019; 108: 218–223.CrossRefGoogle ScholarPubMed
Rakusiewicz, K, Kanigowska, K, Hautz, W, Ziółkowska, L. Choroidal thickness changes in children with chronic heart failure due to dilated cardiomyopathy. Int Ophthalmol 2021; 41: 2167–2177.CrossRefGoogle ScholarPubMed
Pieske, B, Wachter, R, Shah, SJ, et al. Effect of Sacubitril/Valsartan vs Standard Medical Therapies on Plasma NT-proBNP concentration and submaximal exercise capacity in patients with heart failure and preserved ejection fraction: the PARALLAX randomized clinical trial. JAMA 2021; 326: 1919–1929.CrossRefGoogle ScholarPubMed
Senni, M, Lopez-Sendon, J, Cohen-Solal, A, et al. Vericiguat and NT-proBNP in patients with heart failure with reduced ejection fraction: analyses from the VICTORIA trial. ESC Heart Fail 2022; 9: 3791–3803.CrossRefGoogle ScholarPubMed
Voors, AA, Kremer, D, Geven, C, et al. Adrenomedullin in heart failure: pathophysiology and therapeutic application. Eur J Heart Fail 2019; 21: 163–171.CrossRefGoogle ScholarPubMed
Nishikimi, T, Nakagawa, Y. Adrenomedullin as a biomarker of heart failure. Heart Fail Clin 2018; 14: 49–55.CrossRefGoogle ScholarPubMed
Meijers, WC, Bayes-Genis, A, Mebazaa, A, et al. Circulating heart failure biomarkers beyond natriuretic peptides: review from the Biomarker Study Group of the Heart Failure Association (HFA), European Society of Cardiology (ESC). Eur J Heart Fail 2021; 23: 1610–1632.CrossRefGoogle Scholar
Egerstedt, A, Czuba, T, Bronton, K, et al. Bioactive adrenomedullin for assessment of venous congestion in heart failure. ESC Heart Fail 2022; 9: 3543–3555.CrossRefGoogle ScholarPubMed
Xie, C, Zhan, Y, Wu, Y, et al. Expression and clinical significance of serum sST2, BDNF, CTnI, and BUN/Cr in patients with heart failure. Altern Ther Health Med 2023; 29: 176–181.Google ScholarPubMed
Gürgöze, MT, van Vark, LC, Baart, SJ, et al. Multimarker analysis of serially measured GDF-15, NT-proBNP, ST2, GAL-3, cTnI, creatinine, and prognosis in acute heart failure. Circ Heart Fail 2023; 16: e009526.CrossRefGoogle ScholarPubMed