Changes in blood biomarkers correlate with changes in cardiac size and function in patients with tetralogy of Fallot

Wouter J van Genuchten; Eva van den Bosch; Saskia E Luijnenburg; Vivian P Kamphuis; Jolien W Roos-Hesselink; Beatrijs Bartelds; Arno A W Roest; Johannes M P J Breur; Nico A Blom; Eric Boersma; Laurens P Koopman; Willem A Helbing

doi:10.1016/j.ijcchd.2024.100522

Changes in blood biomarkers correlate with changes in cardiac size and function in patients with tetralogy of Fallot

Int J Cardiol Congenit Heart Dis. 2024 Jun 17:17:100522. doi: 10.1016/j.ijcchd.2024.100522. eCollection 2024 Sep.

Authors

Wouter J van Genuchten^{1

2

3}, Eva van den Bosch^{1

2

3}, Saskia E Luijnenburg^{1

2}, Vivian P Kamphuis^{3

4

5}, Jolien W Roos-Hesselink⁶, Beatrijs Bartelds¹, Arno A W Roest⁴, Johannes M P J Breur⁷, Nico A Blom^{4

8}, Eric Boersma⁶, Laurens P Koopman¹, Willem A Helbing^{1

2}

Affiliations

¹ Erasmus University Medical Center, Department of Pediatrics, Division of Pediatric Cardiology, Rotterdam, the Netherlands.
² Erasmus University Medical Center, Department of Radiology, Rotterdam, the Netherlands.
³ Netherlands Heart Institute, Utrecht, the Netherlands.
⁴ Leiden University Medical Center, Department of Pediatrics, Division of Pediatric Cardiology, Leiden, the Netherlands.
⁵ Erasmus University Medical Center, Department of Pediatrics, Rotterdam, the Netherlands.
⁶ Erasmus University Medical Center, Department of Cardiology, Rotterdam, the Netherlands.
⁷ University Medical Center Utrecht, Department of Pediatric Cardiology, Utrecht, the Netherlands.
⁸ Academic Medical Center, Department of Pediatrics, Division of Pediatric Cardiology, Amsterdam, the Netherlands.

Abstract

Introduction: 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).

Methods: 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_pearson) were determined to quantify the relationship between changes in biomarkers and CMR measurements.

Results: 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_pearson 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_pearson between 0.32 and 0.52).

Conclusion: 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.