Chiperi Lacramioara Eliza, Hagau Asmaa Carla, Tecar Cristina, Hutanu Adina, Muntean Iolanda
Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Heart Transplant, Targu Mures, Romania.
George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Targu Mureș, Romania.
Int J Dev Neurosci. 2025 Feb;85(1):e10400. doi: 10.1002/jdn.10400. Epub 2024 Dec 10.
The aim of the study was to assess the predicting value of neuromarkers for psychomotor performances of congenital heart defect (CHD) patients before surgery, as until now the researchers only evaluated neuromarkers after the surgical treatment of the CHD.
This cross-sectional study included children with CHD who did not receive treatment (interventional or cardiac surgery). Psychomotor development was evaluated using the Denver II Screening Test. Blood samples were collected for neuromarkers analysis: neuron-specific enolase (NSE), protein S100 (pS100), brain-derived neurotrophic factor (BDNF), and glial fibrillary acidic protein (GFAP).
We enrolled 77 children. Patients with CHD experienced more frequent developmental delays compared to healthy children (12-34% in the non-cyanotic group and 26-74% in the cyanotic group). The association between type of CHD and psychomotor impairment was statistically significant (p < 0.0001, RR = 2.604, CI = 2.07-3.26). Neuromarkers value was compared between cyanotic and non-cyanotic groups: NSE and BDNF values were higher in the cyanotic group, respectively, pS100 and GFAP had slightly higher values in the non-cyanotic group. A correlation coefficient of 0.35 (p = 0.023) was obtained between psychomotor development and BDNF level. An AUC of 0.72 was obtained for psychomotor development and BDNF in ROC analysis with the cut-off value of 5895 pg/ml.
BDNF is showing moderate discriminative ability in predicting psychomotor development outcomes in pediatric patients with CHD.
本研究的目的是评估神经标志物对先天性心脏病（CHD）患者术前精神运动表现的预测价值，因为到目前为止，研究人员仅在CHD手术治疗后评估神经标志物。
这项横断面研究纳入了未接受治疗（介入治疗或心脏手术）的CHD患儿。使用丹佛发育筛查测验第二版评估精神运动发育情况。采集血样进行神经标志物分析：神经元特异性烯醇化酶（NSE）、蛋白S100（pS100）、脑源性神经营养因子（BDNF）和胶质纤维酸性蛋白（GFAP）。
我们纳入了77名儿童。与健康儿童相比，CHD患者出现发育迟缓的频率更高（非青紫型组为12%-34%，青紫型组为26%-74%）。CHD类型与精神运动障碍之间的关联具有统计学意义（p<0.0001，RR=2.604，CI=2.07-3.26）。比较了青紫型组和非青紫型组的神经标志物值：青紫型组的NSE和BDNF值较高，非青紫型组的pS100和GFAP值略高。精神运动发育与BDNF水平之间的相关系数为0.35（p=0.023）。在ROC分析中，精神运动发育与BDNF的AUC为0.72，临界值为5895 pg/ml。
BDNF在预测CHD儿科患者精神运动发育结果方面显示出中等的判别能力。
