title: Soluble ST2 and N-terminal pro-brain natriuretic peptide combination. Useful biomarker for predicting outcome of childhoodpulmonary arterial hypertension.
abstract: BACKGROUND
  Some potential biomarkers have been reported recently in patients with pulmonary arterial hypertension (PAH), but the most clinically useful among these potential biomarkers, especially in childhood PAH, has not been identified. Therefore, this study investigated which biomarker is useful in assessing severity of and patient prognosis in childhood idiopathic PAH (IPAH)/heritable PAH (HPAH).
  
  
  RESULTS
  Fifty-nine patients who were younger than 16 years at onset of IPAH/HPAH were selected. The following 10 biomarker candidates were quantified: high-sensitivity troponin T, human heart fatty acid-binding protein, N-terminal pro-brain natriuretic peptide (NT-proBNP), pentraxin-3, soluble ST2 (sST2), angiopoietin-2 (Ang-2), matrix metalloproteinase 2, tenascin C, endostatin (ES), and thymidine kinase. Functional characteristics and clinical outcomes were analyzed retrospectively. NT-proBNP, sST2, Ang-2, and ES correlated well with New York Heart Association class. On area under the receiver operating characteristic curve analysis, sST2 had a significantly good relationship with prognosis. On Kaplan-Meier curve and univariate Cox regression analyses, elevated sST2 and NT-proBNP level predicted poor outcome of the present patients with childhood IPAH/HPAH. Furthermore, patients with elevated sST2 had significantly worse prognosis among those with high NT-proBNP.
  
  
  CONCLUSIONS
  The sST2 and NT-proBNP combination is a useful biomarker to predict clinical condition and outcome in patients with childhood IPAH/HPAH.
authors.affiliation: Departments of Pediatrics, National Defense Medical College.
authors.forename: Ayako
authors.initials: A
authors.lastname: Chida
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sato
authors.forename: Masaki
authors.initials: M
authors.lastname: Shintani
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Nakayama
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kawamura
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Furutani
authors.forename: Kei
authors.initials: K
authors.lastname: Inai
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saji
authors.forename: Rumiko
authors.initials: R
authors.lastname: Matsuoka
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Nonoyama
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakanishi
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D000072179:Interleukin-1 Receptor-Like 1 Protein; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000097:blood*
chemical_list: D015415:Biomarkers; C079241:IL1RL1 protein, human; D000072179:Interleukin-1 Receptor-Like 1 Protein; D010446:Peptide Fragments; D011956:Receptors, Cell Surface; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain