Abstract
Introduction
Pulmonary hypertension (PH) is a common comorbidity of cardiopulmonary disease. Endostatin, an inhibitor of angiogenesis, is elevated in neonates with lung disease. ST2 is a heart failure biomarker correlated with PH in adults. We hypothesized that these biomarkers may be useful in diagnosing PH and categorizing its severity in infants.
Methods
Endostatin, ST2, and NT-proBNP plasma concentrations from 26 infants with PH and 21 control infants without PH were correlated with echocardiographic and clinical features using regression models over time.
Results
Endostatin, ST2, and NT-proBNP concentrations were elevated in PH participants versus controls (p < 0.0001). Endostatin was associated with right ventricular dysfunction (p = 0.014), septal flattening (p = 0.047), and pericardial effusion (p < 0.0001). ST2 concentrations predicted right to left patent ductus arteriosus flow (p = 0.009). NT-proBNP was not associated with PH features.
Conclusions
Endostatin and ST2 concentrations were associated with echocardiographic markers of worse PH in infants and may be better predictors than existing clinical standards.
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Change history
08 February 2021
A Correction to this paper has been published: https://doi.org/10.1038/s41372-020-0700-7
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Funding
MG was supported by the Pediatric Scientist Development Program. The Pediatric Scientist Development Program is supported by Award Number K12-HD000850 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. JMC received support from a Johns Hopkins All Children’s Hospital Foundation Institutional Research Grant. The work was supported in part by a Johns Hopkins All Children’s Foundation Institutional Research Grant (PI: N.A. Goldenberg; Johns Hopkins “iPICS” prospective multi-cohort and biobanking study of pediatric acute and chronic health conditions).
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MG, JMC, and ADE planned the project, analyzed the data, and wrote the manuscript; MG and JY performed the experiments and interpreted the results; MG and JMC performed statistical analysis; JY, ADE, MN, MW, JMJ, GF, SMM, and JMC recruited participants and performed research; and all authors reviewed, revised, and approved the manuscript for submission.
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Griffiths, M., Yang, J., Everett, A.D. et al. Endostatin and ST2 are predictors of pulmonary hypertension disease course in infants. J Perinatol 40, 1625–1633 (2020). https://doi.org/10.1038/s41372-020-0671-8
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DOI: https://doi.org/10.1038/s41372-020-0671-8