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Diagnostic performance and reference values of novel biomarkers of paediatric heart failure

ObjectiveBiomarkers play a pivotal role in heart failure (HF) management. Reference values and insights from studies in adults cannot be extrapolated to the paediatric population due to important differences in pathophysiology and compensatory reserve. We assessed the diagnostic utility of four nove... Full description

Journal Title: Heart (British Cardiac Society) 2016-10, Vol.102 (20), p.1633-1639
Main Author: Hauser, Jakob A
Other Authors: Demyanets, Svitlana , Rusai, Krisztina , Goritschan, Clara , Weber, Michael , Panesar, Dilveer , Rindler, Lisa , Taylor, Andrew M , Marculescu, Rodrig , Burch, Michael , Wojta, Johann , Michel-Behnke, Ina
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: British Medical Association
ID: ISSN: 1355-6037
Link: https://www.ncbi.nlm.nih.gov/pubmed/27220692
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title: Diagnostic performance and reference values of novel biomarkers of paediatric heart failure
format: Article
creator:
  • Hauser, Jakob A
  • Demyanets, Svitlana
  • Rusai, Krisztina
  • Goritschan, Clara
  • Weber, Michael
  • Panesar, Dilveer
  • Rindler, Lisa
  • Taylor, Andrew M
  • Marculescu, Rodrig
  • Burch, Michael
  • Wojta, Johann
  • Michel-Behnke, Ina
subjects:
  • Abridged Index Medicus
  • Adolescent
  • Adrenomedullin - blood
  • Age Factors
  • Analysis
  • Area Under Curve
  • Atrial Natriuretic Factor - blood
  • Austria
  • Biological markers
  • Biomarkers - blood
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Diagnosis
  • Echocardiography
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Fluorescent Antibody Technique
  • Growth Differentiation Factor 15 - blood
  • Heart failure
  • Heart Failure - blood
  • Heart Failure - diagnosis
  • Heart Failure - etiology
  • Heart Failure - physiopathology
  • Humans
  • Infant
  • Infant, Newborn
  • Interleukin-1 Receptor-Like 1 Protein - blood
  • Magnetic Resonance Imaging
  • Male
  • Natriuretic Peptide, Brain - blood
  • Peptide Fragments - blood
  • Predictive Value of Tests
  • Protein Precursors - blood
  • Reference Values
  • Reference values (Medicine)
  • Reproducibility of Results
  • Risk factors
  • ROC Curve
  • United Kingdom
  • Usage
  • Young Adult
ispartof: Heart (British Cardiac Society), 2016-10, Vol.102 (20), p.1633-1639
description: ObjectiveBiomarkers play a pivotal role in heart failure (HF) management. Reference values and insights from studies in adults cannot be extrapolated to the paediatric population due to important differences in pathophysiology and compensatory reserve. We assessed the diagnostic utility of four novel biomarkers in paediatric HF.MethodsMidregional (MR) pro-atrial natriuretic peptide (proANP), soluble ST2 (sST2), growth differentiation factor-15 (GDF-15), MR-pro-adrenomedullin (proADM) and N-terminal pro-B natriuretic peptide (NT-proBNP) were measured in 114 patients and 89 controls. HF was defined as the presence of HF symptoms and/or abnormal systolic ventricular function. Receiver-operating characteristics were plotted, and the area under the curve (AUC) was measured. This was repeated for subgroups with cardiomyopathy and congenital heart disease (CHD). Ventricular systolic function was measured by magnetic resonance or echocardiography. Reference values were calculated according to the current guidelines.ResultsThe AUC for diagnosing HF was 0.76 for MR-proANP (CI 0.70 to 0.84) and 0.82 for NT-proBNP (CI 0.75 to 0.88). These parameters performed similarly in the subgroups with CHD and cardiomyopathy. By contrast, MR-proADM, GDF-15 and sST2 performed poorly. When used in conjunction with NT-proBNP, no parameter added significantly to its diagnostic accuracy. NT-proBNP, MR-proANP, GDF-15 and sST2 could accurately discriminate between patients with preserved and patients with poor functional status. In a subset of patients with dilated cardiomyopathy, NT-proBNP, MR-proANP, MR-proADM and GDF-15 were associated with poor LV function.ConclusionsMR-proANP could accurately detect HF in children and adolescents. Its diagnostic performance was comparable with that of NT-proBNP, regardless of the underlying condition. Reference values are presented.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titleDiagnostic performance and reference values of novel biomarkers of paediatric heart failure
sourceAlma/SFX Local Collection
creatorHauser, Jakob A ; Demyanets, Svitlana ; Rusai, Krisztina ; Goritschan, Clara ; Weber, Michael ; Panesar, Dilveer ; Rindler, Lisa ; Taylor, Andrew M ; Marculescu, Rodrig ; Burch, Michael ; Wojta, Johann ; Michel-Behnke, Ina
creatorcontribHauser, Jakob A ; Demyanets, Svitlana ; Rusai, Krisztina ; Goritschan, Clara ; Weber, Michael ; Panesar, Dilveer ; Rindler, Lisa ; Taylor, Andrew M ; Marculescu, Rodrig ; Burch, Michael ; Wojta, Johann ; Michel-Behnke, Ina
descriptionObjectiveBiomarkers play a pivotal role in heart failure (HF) management. Reference values and insights from studies in adults cannot be extrapolated to the paediatric population due to important differences in pathophysiology and compensatory reserve. We assessed the diagnostic utility of four novel biomarkers in paediatric HF.MethodsMidregional (MR) pro-atrial natriuretic peptide (proANP), soluble ST2 (sST2), growth differentiation factor-15 (GDF-15), MR-pro-adrenomedullin (proADM) and N-terminal pro-B natriuretic peptide (NT-proBNP) were measured in 114 patients and 89 controls. HF was defined as the presence of HF symptoms and/or abnormal systolic ventricular function. Receiver-operating characteristics were plotted, and the area under the curve (AUC) was measured. This was repeated for subgroups with cardiomyopathy and congenital heart disease (CHD). Ventricular systolic function was measured by magnetic resonance or echocardiography. Reference values were calculated according to the current guidelines.ResultsThe AUC for diagnosing HF was 0.76 for MR-proANP (CI 0.70 to 0.84) and 0.82 for NT-proBNP (CI 0.75 to 0.88). These parameters performed similarly in the subgroups with CHD and cardiomyopathy. By contrast, MR-proADM, GDF-15 and sST2 performed poorly. When used in conjunction with NT-proBNP, no parameter added significantly to its diagnostic accuracy. NT-proBNP, MR-proANP, GDF-15 and sST2 could accurately discriminate between patients with preserved and patients with poor functional status. In a subset of patients with dilated cardiomyopathy, NT-proBNP, MR-proANP, MR-proADM and GDF-15 were associated with poor LV function.ConclusionsMR-proANP could accurately detect HF in children and adolescents. Its diagnostic performance was comparable with that of NT-proBNP, regardless of the underlying condition. Reference values are presented.
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0ISSN: 1355-6037
1EISSN: 1468-201X
2DOI: 10.1136/heartjnl-2016-309460
3PMID: 27220692
languageeng
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subjectAbridged Index Medicus ; Adolescent ; Adrenomedullin - blood ; Age Factors ; Analysis ; Area Under Curve ; Atrial Natriuretic Factor - blood ; Austria ; Biological markers ; Biomarkers - blood ; Case-Control Studies ; Child ; Child, Preschool ; Diagnosis ; Echocardiography ; Enzyme-Linked Immunosorbent Assay ; Female ; Fluorescent Antibody Technique ; Growth Differentiation Factor 15 - blood ; Heart failure ; Heart Failure - blood ; Heart Failure - diagnosis ; Heart Failure - etiology ; Heart Failure - physiopathology ; Humans ; Infant ; Infant, Newborn ; Interleukin-1 Receptor-Like 1 Protein - blood ; Magnetic Resonance Imaging ; Male ; Natriuretic Peptide, Brain - blood ; Peptide Fragments - blood ; Predictive Value of Tests ; Protein Precursors - blood ; Reference Values ; Reference values (Medicine) ; Reproducibility of Results ; Risk factors ; ROC Curve ; United Kingdom ; Usage ; Young Adult
ispartofHeart (British Cardiac Society), 2016-10, Vol.102 (20), p.1633-1639
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0Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
1Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
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1Demyanets, Svitlana
2Rusai, Krisztina
3Goritschan, Clara
4Weber, Michael
5Panesar, Dilveer
6Rindler, Lisa
7Taylor, Andrew M
8Marculescu, Rodrig
9Burch, Michael
10Wojta, Johann
11Michel-Behnke, Ina
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1Heart (British Cardiac Society)
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descriptionObjectiveBiomarkers play a pivotal role in heart failure (HF) management. Reference values and insights from studies in adults cannot be extrapolated to the paediatric population due to important differences in pathophysiology and compensatory reserve. We assessed the diagnostic utility of four novel biomarkers in paediatric HF.MethodsMidregional (MR) pro-atrial natriuretic peptide (proANP), soluble ST2 (sST2), growth differentiation factor-15 (GDF-15), MR-pro-adrenomedullin (proADM) and N-terminal pro-B natriuretic peptide (NT-proBNP) were measured in 114 patients and 89 controls. HF was defined as the presence of HF symptoms and/or abnormal systolic ventricular function. Receiver-operating characteristics were plotted, and the area under the curve (AUC) was measured. This was repeated for subgroups with cardiomyopathy and congenital heart disease (CHD). Ventricular systolic function was measured by magnetic resonance or echocardiography. Reference values were calculated according to the current guidelines.ResultsThe AUC for diagnosing HF was 0.76 for MR-proANP (CI 0.70 to 0.84) and 0.82 for NT-proBNP (CI 0.75 to 0.88). These parameters performed similarly in the subgroups with CHD and cardiomyopathy. By contrast, MR-proADM, GDF-15 and sST2 performed poorly. When used in conjunction with NT-proBNP, no parameter added significantly to its diagnostic accuracy. NT-proBNP, MR-proANP, GDF-15 and sST2 could accurately discriminate between patients with preserved and patients with poor functional status. In a subset of patients with dilated cardiomyopathy, NT-proBNP, MR-proANP, MR-proADM and GDF-15 were associated with poor LV function.ConclusionsMR-proANP could accurately detect HF in children and adolescents. Its diagnostic performance was comparable with that of NT-proBNP, regardless of the underlying condition. Reference values are presented.
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1Adolescent
2Adrenomedullin - blood
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6Atrial Natriuretic Factor - blood
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10Case-Control Studies
11Child
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13Diagnosis
14Echocardiography
15Enzyme-Linked Immunosorbent Assay
16Female
17Fluorescent Antibody Technique
18Growth Differentiation Factor 15 - blood
19Heart failure
20Heart Failure - blood
21Heart Failure - diagnosis
22Heart Failure - etiology
23Heart Failure - physiopathology
24Humans
25Infant
26Infant, Newborn
27Interleukin-1 Receptor-Like 1 Protein - blood
28Magnetic Resonance Imaging
29Male
30Natriuretic Peptide, Brain - blood
31Peptide Fragments - blood
32Predictive Value of Tests
33Protein Precursors - blood
34Reference Values
35Reference values (Medicine)
36Reproducibility of Results
37Risk factors
38ROC Curve
39United Kingdom
40Usage
41Young Adult
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authorHauser, Jakob A ; Demyanets, Svitlana ; Rusai, Krisztina ; Goritschan, Clara ; Weber, Michael ; Panesar, Dilveer ; Rindler, Lisa ; Taylor, Andrew M ; Marculescu, Rodrig ; Burch, Michael ; Wojta, Johann ; Michel-Behnke, Ina
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1Adolescent
2Adrenomedullin - blood
3Age Factors
4Analysis
5Area Under Curve
6Atrial Natriuretic Factor - blood
7Austria
8Biological markers
9Biomarkers - blood
10Case-Control Studies
11Child
12Child, Preschool
13Diagnosis
14Echocardiography
15Enzyme-Linked Immunosorbent Assay
16Female
17Fluorescent Antibody Technique
18Growth Differentiation Factor 15 - blood
19Heart failure
20Heart Failure - blood
21Heart Failure - diagnosis
22Heart Failure - etiology
23Heart Failure - physiopathology
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26Infant, Newborn
27Interleukin-1 Receptor-Like 1 Protein - blood
28Magnetic Resonance Imaging
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30Natriuretic Peptide, Brain - blood
31Peptide Fragments - blood
32Predictive Value of Tests
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37Risk factors
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8Marculescu, Rodrig
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2Rusai, Krisztina
3Goritschan, Clara
4Weber, Michael
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7Taylor, Andrew M
8Marculescu, Rodrig
9Burch, Michael
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abstractObjectiveBiomarkers play a pivotal role in heart failure (HF) management. Reference values and insights from studies in adults cannot be extrapolated to the paediatric population due to important differences in pathophysiology and compensatory reserve. We assessed the diagnostic utility of four novel biomarkers in paediatric HF.MethodsMidregional (MR) pro-atrial natriuretic peptide (proANP), soluble ST2 (sST2), growth differentiation factor-15 (GDF-15), MR-pro-adrenomedullin (proADM) and N-terminal pro-B natriuretic peptide (NT-proBNP) were measured in 114 patients and 89 controls. HF was defined as the presence of HF symptoms and/or abnormal systolic ventricular function. Receiver-operating characteristics were plotted, and the area under the curve (AUC) was measured. This was repeated for subgroups with cardiomyopathy and congenital heart disease (CHD). Ventricular systolic function was measured by magnetic resonance or echocardiography. Reference values were calculated according to the current guidelines.ResultsThe AUC for diagnosing HF was 0.76 for MR-proANP (CI 0.70 to 0.84) and 0.82 for NT-proBNP (CI 0.75 to 0.88). These parameters performed similarly in the subgroups with CHD and cardiomyopathy. By contrast, MR-proADM, GDF-15 and sST2 performed poorly. When used in conjunction with NT-proBNP, no parameter added significantly to its diagnostic accuracy. NT-proBNP, MR-proANP, GDF-15 and sST2 could accurately discriminate between patients with preserved and patients with poor functional status. In a subset of patients with dilated cardiomyopathy, NT-proBNP, MR-proANP, MR-proADM and GDF-15 were associated with poor LV function.ConclusionsMR-proANP could accurately detect HF in children and adolescents. Its diagnostic performance was comparable with that of NT-proBNP, regardless of the underlying condition. Reference values are presented.
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