How to interpret cardiac biomarkers in children?
Claire McGinnThomas WaterfieldGareth McKeemanLouise MorrisonSinead CallaghanChris WatsonFrank A CaseyPublished in: Archives of disease in childhood. Education and practice edition (2022)
Cardiac biomarkers are used as first-line diagnostic tools in suspected myocardial injury and heart failure in adult patients. Their use in paediatric patients has been limited by variability caused by age, gender and the presence of an underlying congenital cardiac condition. There are established reference ranges for both NT-proBNP and troponin in healthy children, but these cannot be applied to all paediatric patients because of limited large studies focusing on children with congenital heart disease and/or cardiomyopathy.This article will focus on the pathophysiology of myocardial injury and heart failure in children and the subsequent cardiac biomarker correlation. It will explain how to interpret the biomarker assay levels obtained for both troponin and NT-proBNP and highlights the importance of a clear clinical question prior to requesting a cardiac biomarker assay level.Clinical cases outline scenarios that may prompt consideration of biomarker analysis in children and aims to equip the reader with an understanding of how to interpret the results.
Keyphrases
- heart failure
- left ventricular
- end stage renal disease
- young adults
- chronic kidney disease
- ejection fraction
- newly diagnosed
- intensive care unit
- emergency department
- peritoneal dialysis
- prognostic factors
- high throughput
- mental health
- patient reported outcomes
- atrial fibrillation
- climate change
- pulmonary embolism
- cardiac resynchronization therapy
- patient reported