Circulating High Mobility Group Box-1 Does Not Predict Pulmonary Arterial Hypertension in Children with Congenital Heart Disease: A Prospective Cohort Study.

Autor: Caracci, Bruno, Pehora, Carolyne, Benson, Lee, Steinberg, Benjamin E., Goldenberg, Neil M., Taylor, Katherine
Zdroj: Journal of Cardiothoracic & Vascular Anesthesia; Oct2024, Vol. 38 Issue 10, p2356-2361, 6p
Abstrakt: • Pulmonary hypertension associated with congenital heart disease is a major cause of mortality in pediatrics. • Gold standard diagnosis includes right heart catheterization, which itself is of high risk. • In adults with congenital heart disease-pulmonary arterial hypertension, high mobility group box-1 (HGMB1) correlated with mean pulmonary arterial pressure and pulmonary vascular resistance, and fell in response to sildenafil therapy. • Our study failed to demonstrate HGMB1 as a biomarker for pulmonary hypertension in children with congenital heart disease. Pulmonary arterial hypertension (PAH) is a devastating complication of pediatric congenital heart disease (CHD). A recent study has identified the protein high mobility group box-1 (HMGB1) as a diagnostic tool in adults with CHD-associated PAH. HMGB1 levels in adults with CHD-associated PAH correlated with mean pulmonary artery pressure and pulmonary vascular resistance, and HGMB1 levels fell in response to sildenafil therapy. We wanted to assess if HGMB1 was a biomarker of pediatric CHD-PAH. Prospective cohort study. Quaternary pediatric academic hospital Children ≤18 years with CHD with and without known pulmonary hypertension. Controls were children undergoing dental or urologic surgery with no known heart disease. Pulmonary hemodynamics, echocardiographic assessment, and biomarker measurement. Controls had biomarker measurement only. Patients with CHD-PAH had mean pulmonary vascular resistance index of 10 Wood units/m2. Neither HGMB1 nor N-terminal pro-brain-type natriuretic peptide levels were significantly different between the groups. Neither marker correlated with pulmonary hypertension. Unlike in adults, HGMB1 is not a biomarker of PAH in pediatric CHD. Further work will continue to explore for biomarkers for this high-risk population. [ABSTRACT FROM AUTHOR]
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