Rosetta Ragusa1, Concetta Prontera2, Arianna Di Molfetta3, Manuela Cabiati4, Silvia Masotti1, Silvia Del Ry5, Antonio Amodeo3, Maria Giovanna Trivella4, Aldo Clerico6, Chiara Caselli7. 1. Scuola Superiore Sant'Anna, Institute of Life Sciences, Pisa, Italy. 2. Fondazione Toscana Gabriele Monasterio, Pisa, Italy. 3. Department of Cardiothoracic Surgery, Ospedale Bambino Gesù, Rome, Italy. 4. CNR, Institute of Clinical Physiology, Laboratory of Biochemistry and Molecular Biology, Pisa, Italy. 5. Scuola Superiore Sant'Anna, Institute of Life Sciences, Pisa, Italy; CNR, Institute of Clinical Physiology, Laboratory of Biochemistry and Molecular Biology, Pisa, Italy. 6. Scuola Superiore Sant'Anna, Institute of Life Sciences, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy. 7. CNR, Institute of Clinical Physiology, Laboratory of Biochemistry and Molecular Biology, Pisa, Italy. Electronic address: chiara.caselli@ifc.cnr.it.
Abstract
BACKGROUND: Ventricular Assist Device (VAD) as bridge to transplantation is a common therapy for adult with heart failure (HF), but VAD use is increasing also in children. Cardiac and inflammatory biomarkers have an important role in the diagnosis and prognosis of HF in adults, but their role in paediatric setting is unknown. The aim of this study was to examine changes in cardiac and inflammatory biomarkers, both in HF paediatric and adult patients, before and following VAD. METHODS: Cardiac (NT-proBNP, cTnI, sST2,Gal-3) and inflammatory (IL-6,IL-8) biomarkers were determined in plasma collected from 12 paediatric patients and 7 adult patients with HF, before and at 4 h,1,3,7,14 and 30 days after VAD implant. RESULTS: All biomarkers increased up to 1 day after VAD implant and then decreased at pre-VAD levels in 1 month in both groups. Only in children, NT-proBNP decreased significantly after 30 days Post-VAD treatment compared to pre-VAD levels. During the post-operative time-course, NT-proBNP and sST2 were significantly higher in children than adults, while IL-6 was lower. CONCLUSIONS: Cardiac and inflammatory biomarkers were differently modified by VAD implant in children compared to adults. These preliminary data could suggest that different molecular pathways may underlie HF patho-physiology of the two groups, possibly paving the way to a specific and targeted therapeutic intervention in the near future.
BACKGROUND: Ventricular Assist Device (VAD) as bridge to transplantation is a common therapy for adult with heart failure (HF), but VAD use is increasing also in children. Cardiac and inflammatory biomarkers have an important role in the diagnosis and prognosis of HF in adults, but their role in paediatric setting is unknown. The aim of this study was to examine changes in cardiac and inflammatory biomarkers, both in HF paediatric and adult patients, before and following VAD. METHODS: Cardiac (NT-proBNP, cTnI, sST2,Gal-3) and inflammatory (IL-6,IL-8) biomarkers were determined in plasma collected from 12 paediatric patients and 7 adult patients with HF, before and at 4 h,1,3,7,14 and 30 days after VAD implant. RESULTS: All biomarkers increased up to 1 day after VAD implant and then decreased at pre-VAD levels in 1 month in both groups. Only in children, NT-proBNP decreased significantly after 30 days Post-VAD treatment compared to pre-VAD levels. During the post-operative time-course, NT-proBNP and sST2 were significantly higher in children than adults, while IL-6 was lower. CONCLUSIONS: Cardiac and inflammatory biomarkers were differently modified by VAD implant in children compared to adults. These preliminary data could suggest that different molecular pathways may underlie HF patho-physiology of the two groups, possibly paving the way to a specific and targeted therapeutic intervention in the near future.