title: Cardiac biomarkers in HIV-exposed uninfected children.
abstract: OBJECTIVE
  To evaluate associations of cardiac biomarkers with in-utero antiretroviral drug exposures and cardiac function/structure measured by echocardiograms in HIV-exposed but uninfected (HEU) children.
  
  
  METHODS
  We analyzed the association of three cardiac biomarkers (cardiac troponin T, cTnT; high sensitivity C-reactive protein, hsCRP; and N-terminal pro-brain natriuretic peptide, NT-proBNP) with prenatal antiretroviral drug exposures, maternal-child characteristics, and echocardiographic parameters.
  
  
  RESULTS
  Among 338 HEU children (mean age 4.3 years), 51% had at least one elevated cardiac biomarker. Maternal tobacco use was associated with elevated NT-proBNP [adjusted odds ratio (aOR) 2.28, P=0.02]. Maternal alcohol and abacavir use were associated with elevated cTnT levels (aOR 3.56, P=0.01 and aOR 2.33, P=0.04, respectively). Among 94 children with paired echocardiogram-biomarker measurements, cTnT measurements were correlated with increased left-ventricular thickness-to-dimension ratio (r=0.21, P=0.04); and elevated cTnT was associated with higher mean left-ventricular end-diastolic (LVED) posterior wall thickness (P=0.04). hsCRP measurements were negatively correlated with septal thickness (r=-0.22, P=0.03) and elevated hsCRP was associated with lower mean left-ventricular contractility Z-scores (P=0.04). NT-proBNP measurements were correlated with increased LVED dimension (r=0.20, P=0.05) and elevated NT-proBNP was associated with lower mean end-systolic septal thickness (P=0.03).
  
  
  CONCLUSIONS
  Our findings suggest that cardiac biomarkers may help identify HEU children who require further cardiac evaluation including echocardiography. Potential cardiac effects of prenatal abacavir exposure in this population need further investigation.
authors.affiliation: Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Wilkinson
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
authors.forename: Erin
authors.initials: E
authors.lastname: Leister
authors.forename: Bret
authors.initials: B
authors.lastname: Zeldow
authors.forename: William T
authors.initials: WT
authors.lastname: Shearer
authors.forename: Steven D
authors.initials: SD
authors.lastname: Colan
authors.forename: George K
authors.initials: GK
authors.lastname: Siberry
authors.forename: Laurie B
authors.initials: LB
authors.lastname: Dooley
authors.forename: Gwendolyn B
authors.initials: GB
authors.lastname: Scott
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Rich
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lipshultz
mesh_terms: D000428:Alcohol Drinking; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016241:Child of Impaired Parents; D002675:Child, Preschool; D015224:Dideoxynucleosides / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood; D008297:Male; D009035:Mothers; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000139:chemically induced / Q000821:virology; D012307:Risk Factors; D012907:Smoking; D020107:Troponin T / Q000097:blood; D014481:United States / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000187:drug effects*; D019562:Viral Load; D000099227:Abacavir
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D015224:Dideoxynucleosides; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D020107:Troponin T; D000099227:Abacavir; C109794:pro-brain natriuretic peptide (1-76)