Correlation of serum biomarkers in adults with single ventricles with strain and strain rate using 2D speckle tracking.
BACKGROUND
With advances in cardiac care, patients with congenital heart disease, including single ventricle (SV) physiology, now survive into adulthood. These patients often suffer from congestive heart failure (CHF) with overexpression of serum biomarkers. Strain and strain rate (SR) may better describe the myocardial mechanics of a failing SV. Our objective was to determine the correlation between strain/SR and biomarkers in adult patients with SV and CHF.


METHODS
Adult patients (age ≥8 years) with a SV were enrolled. Strain/SR in a 16-segment model of a SV was measured using 2D speckle echocardiography. Serum levels of interleukin 6, interleukin 8, matrix metalloproteinase 9, procollagen I C-terminal peptide (PCIP), cross-linked carboxy-terminal telopeptide of type I collagen (ICTP), pro-B-type natriuretic peptide, nitrotryrosine, tissue growth factor beta (TGF-β), tumor necrosis factor alpha, vascular endothelial growth factor, and creatinine (Cr) were measured. Patients underwent a complete 6 Minute Walk Test (MWT). Pearson correlation coefficient was used. P <.05 was considered significant.


RESULTS
Ten patients with SV (LV = 7, RV = 3) were enrolled. Mean age was 35.5 years (25-42 years). Mean single ventricular ejection fraction (SVEF) was 47%. ICTP correlated with the basal, mid, and apical anterolateral SR, as well as apical anterior and inferior SR. PCIP correlated with mid anterolateral, basal anteroseptal, and mid inferolateral SR. TGF-β correlated with apical inferior SR. Cr correlated with mid inferior-septal and apical lateral SR. 6 MWT negatively correlated with the apical anterior septum SR.


CONCLUSIONS
ICTP, Cr, and PCIP correlated best with segmental SR values. Our results provide a preliminary platform for future studies to follow the results of treatment modalities using strain/SR and biomarkers for CHF in this population.
Columbus Ohio Adult Congenital Heart Disease Program, The Heart Center, Nationwide Children's Hospital, Columbus, OH 43205, USA. ali.zaidi@osumc.edu
Ali N
AN
Zaidi
Leah
L
White
Roger
R
Holt
Mary
M
Cismowski
Lisa
L
Nicholson
Stephen C
SC
Cook
Curt J
CJ
Daniels
Clifford L
CL
Cua
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001696:Biomechanical Phenomena; D024042:Collagen Type I / Q000097:blood*; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D018729:Fontan Procedure / Q000009:adverse effects; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume; D014463:Ultrasonography; D016276:Ventricular Function
D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D003404:Creatinine