title: Cardiac biomarkers in children with congenital heart disease.
abstract: BACKGROUND
  Most congenital heart diseases (CHDs) have specific hemodynamics, including volume and pressure overload, as well as cyanosis and pulmonary hypertension, associated with anatomical abnormalities. Such hemodynamic abnormalities can cause activation of neurohormones, inflammatory cytokines, fibroblasts, and vascular endothelial cells, which in turn contribute to the development of pathologic conditions such as cardiac hypertrophy, fibrosis, and cardiac cell damages and death. Measuring biomarker levels facilitates the prediction of these pathological changes, and provides information about the stress placed on the myocardial cells, the severity of the damage, the responses of neurohumoral factors, and the remodeling of the ventricle. Compared to the ample information on cardiac biomarkers in adult heart diseases, data from children with CHD are still limited.
  
  
  METHODS
  We reviewed cardiac biomarkers-specifically focusing on troponin as a biomarker of myocardial damage, amino-terminal procollagen type III peptide (PIIIP) as a biomarker of myocardial fibrosis and stromal remodeling, and B-type natriuretic peptide (BNP)/N-terminal proBNP as biomarkers of cardiac load and heart failure, by introducing relevant publications, including our own, on pediatric CHD patients as well as adults.
  
  
  RESULTS
  Levels of highly sensitive troponin I are elevated in patients with atrial septal defects (ASDs) and ventricular septal defects (VSDs). PIIIP levels are also elevated in patients with ASD, VSD, pulmonary stenosis, and Tetralogy of Fallot. Measurement of BNP and N-terminal proBNP levels shows good correlation with heart failure score in children.
  
  
  CONCLUSIONS
  In the treatment of children with CHD requiring delicate care, it is vital to know the specific degree of myocardial damage and severity of heart failure. Cardiac biomarkers are useful tools for ascertaining the condition of CHDs with ease and are likely to be useful in determining the appropriate care of pediatric cardiology patients.
authors.affiliation: , Asahikawa, Japan.|Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: , Asahikawa, Japan.|Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Kuwata
authors.affiliation: , Asahikawa, Japan.|Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
authors.forename: Clara
authors.initials: C
authors.lastname: Kurishima
authors.affiliation: , Asahikawa, Japan.|Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
authors.forename: Jeong Hye
authors.initials: JH
authors.lastname: Kim
authors.affiliation: , Asahikawa, Japan.|Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
authors.forename: Yoich
authors.initials: Y
authors.lastname: Iwamoto
authors.affiliation: , Asahikawa, Japan. hsenzaki@saitama-med.ac.jp.|Department of Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan. hsenzaki@saitama-med.ac.jp.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Senzaki
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000097:blood*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood*; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; D014336:Troponin; C109794:pro-brain natriuretic peptide (1-76); C041876:procollagen Type III-N-terminal peptide; D020097:Natriuretic Peptide, Brain
keywords: B-type natriuretic peptide; biomarker; congenital heart disease; procollagen type III peptide; troponin