van Genuchten Wouter J, van den Bosch Eva, Luijnenburg Saskia E, Kamphuis Vivian P, Roos-Hesselink Jolien W, Bartelds Beatrijs, Roest Arno A W, Breur Johannes M P J, Blom Nico A, Boersma Eric, Koopman Laurens P, Helbing Willem A
Erasmus University Medical Center, Department of Pediatrics, Division of Pediatric Cardiology, Rotterdam, the Netherlands.
Erasmus University Medical Center, Department of Radiology, Rotterdam, the Netherlands.
Int J Cardiol Congenit Heart Dis. 2024 Jun 17;17:100522. doi: 10.1016/j.ijcchd.2024.100522. eCollection 2024 Sep.
Patients after surgical correction of Tetralogy of Fallot (ToF) often show adverse cardiac remodeling. To better understand the underlying biological processes, we studied the relation between changes in blood biomarkers and changes in biventricular size and function as assessed by cardiac magnetic resonance imaging (CMR).
This study included 50 ToF patients, who underwent blood biomarker and CMR analysis at least twice between 2002 and 2018.34 (68 %) of these patients were male. Patients had an average age of 16.1 at first visit. Biomarkers were chosen based on earlier research by our group and included: NT-proBNP, ST2, GDF-15, DLK-1, IGFBP-1/7, and FABP-4. Pearson correlations coefficients (r) were determined to quantify the relationship between changes in biomarkers and CMR measurements.
For changes in parameters of right ventricular (RV) size significant correlations were observed with changes in NT-proBNP, ST-2, GDF-15, IGFBP7 and FABP-4 (r between 0.28 and 0.51). Correlations with NT-proBNP were driven by changes in RV size induced by pulmonary valve replacement (n = 9). For LV serial size changes, significant correlations were noted with changes in NT-pro-BNP, ST-2, GDF-15 and FABP-4 (r between 0.32 and 0.52).
In clinically stable ToF patients changes in right and left ventricular size and function correlated with alterations in blood biomarkers of inflammation and immune response to stress.
法洛四联症（ToF）手术矫正后的患者常出现不良心脏重塑。为了更好地理解潜在的生物学过程，我们研究了血液生物标志物变化与心脏磁共振成像（CMR）评估的双心室大小和功能变化之间的关系。
本研究纳入了50例ToF患者，他们在2002年至2018年间至少接受了两次血液生物标志物和CMR分析。其中34例（68%）为男性。患者首次就诊时的平均年龄为16.1岁。生物标志物是根据我们团队早期的研究选择的，包括：N末端脑钠肽前体（NT-proBNP）、ST2、生长分化因子15（GDF-15）、delta样蛋白1（DLK-1）、胰岛素样生长因子结合蛋白1/7（IGFBP-1/7）和脂肪酸结合蛋白4（FABP-4）。通过计算Pearson相关系数（r）来量化生物标志物变化与CMR测量值之间的关系。
右心室（RV）大小参数的变化与NT-proBNP、ST-2、GDF-15、IGFBP7和FABP-4的变化显著相关（r在0.28至0.51之间）。与NT-proBNP的相关性是由肺动脉瓣置换引起的RV大小变化驱动的（n = 9）。对于左心室大小的连续变化，与NT-pro-BNP、ST-2、GDF-15和FABP-4的变化显著相关（r在0.32至0.52之间）。
在临床稳定的ToF患者中，右心室和左心室大小及功能的变化与炎症和应激免疫反应的血液生物标志物改变相关。
