Multisystem inflammatory syndrome in children: Inputs of BNP, NT-proBNP and Galectin-3

Raynor, Alexandre; C, Vallee; Belkarfa, A.-L.; Lunte, Klara; Laney, Maude; Belhadjer, Zahra; Vicca, Stéphanie; Boutten, Anne; Bonnet, Damien; Nivet-Antoine, Valérie

doi:10.1016/j.cca.2022.02.011

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Previous studies revealed that increased concentrations of NT-proBNP correlated with worse left ventricular function and a higher risk of cardiogenic shock [49,57]. Raynor's study showed that increased NT-proBNP correlated with the severity of left ventricular dysfunction and was a better marker than BNP [58]. On the other hand, Fridman found that higher troponin I, not NT-proBNP, was associated with decreased LVEF [59].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Involvement in Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) in Poland

et al. 2023

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Multisystem inflammatory syndrome in children (MIS-C) is an immune-mediated complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cardiovascular system is commonly involved. Acute heart failure (AHF) is the most severe complication of MIS-C, leading to cardiogenic shock. The aim of the study was to characterise the course of MIS-C with a focus on cardiovascular involvement, based on echocardiographic (echo) evaluation, in 498 children (median age 8.3 years, 63% boys) hospitalised in 50 cities in Poland. Among them, 456 (91.5%) had cardiovascular system involvement: 190 (48.2%) of patients had (most commonly atrioventricular) valvular insufficiency, 155 (41.0%) had contractility abnormalities and 132 (35.6%) had decreased left ventricular ejection fraction (LVEF < 55%). Most of these abnormalities improved within a few days. Analysis of the results obtained from two echo descriptions (a median of 5 days apart) revealed a >10% increase in LVEF even in children with primarily normal LVEF. Lower levels of lymphocytes, platelets and sodium and higher levels of inflammatory markers on admission were significantly more common among older children with contractility dysfunction, while younger children developed coronary artery abnormality (CAA) more often. The incidence of ventricular dysfunction might be underestimated. The majority of children with AHF improved significantly within a few days. CAAs were relatively rare. Children with impaired contractility as well as other cardiac abnormalities differed significantly from children without such conditions. Due to the exploratory nature of this study, these findings should be confirmed in further studies.

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Section: Discussionmentioning

confidence: 99%

Cardiac Involvement in Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) in Poland

et al. 2023

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“…79,81,82 In some instances, coronary abnormalities and cardiogenic shock can present following either Kawasaki Disease or Multisystem Inflammatory Syndrome in Children, where coronary artery aneurysm and dilatation were observed for the former. 78,83,84 Cardiogenic shock is a condition of poor cardiac efficiency in which the cardiac output is severely reduced, whether due to arrhythmias, instances of myocarditis, or ventricular dysfunction. 85 In a study by Lemm et al, NT-proBNP levels were elevated in patients with cardiogenic shock, which may have been heavily dependent on impaired renal function, suggesting and reflecting additional organ dysfunction.…”

Section: Nt-probnp In Paediatricsmentioning

confidence: 99%

“…78 Although NT-proBNP and brain natriuretic peptide are both robust monitors of cardiac function, NT-proBNP seems to be more sensitive in detecting heart failure. Indeed, in a 2022 French study on paediatric patients with positive Severe Acute Respiratory Syndrome Coronavirus 2 tests, Raynor et al 83 suggest that due to kinetic differences between the two molecules, NT-proBNP is to be favoured over brain natriuretic peptide in detecting heart failure, at least in Multisystem Inflammatory Syndrome in Children patients.…”

Section: In the Paediatric Populationmentioning

confidence: 99%

NT-proBNP cardiac value in COVID-19: a focus on the paediatric population

Sleem,

El Rassi,

Zareef

et al. 2024

Cardiol Young

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NT-proBNP is a peptide related to brain natriuretic peptide, a cardiac biomarker and a member of the natriuretic family of peptides. NT-proBNP has demonstrated its clinical utility in the assessment of a wide spectrum of cardiac manifestations. It is also considered a more precise diagnostic and prognostic cardiac biomarker than brain natriuretic peptide. With the appearance of the Severe Acute Respiratory Syndrome Coronavirus 2 virus and the subsequent COVID-19 pandemic, diagnosis of heart implications began to pose an increasing struggle for the physician. Echocardiography is considered a central means of evaluating cardiac disorders like heart failure, and it is considered a reliable method. However, other diagnostic methods are currently being explored, one of which involves the assessment of NT-proBNP levels. In the literature that involves the adult population, significant positive correlations were drawn between the levels of NT-proBNP and COVID-19 outcomes such as high severity and fatality. In the paediatric population, however, the literature is scarce, and most of the investigations assess NT-proBNP in the context of Multiple Inflammatory Syndrome in Children, where studies have shown that cohorts with this syndrome had elevated levels of NT-proBNP when compared to non-syndromic cohorts. Thus, more large-scale studies on existing COVID-19 data should be carried out in the paediatric population to further understand the prognostic and diagnostic roles of NT-proBNP.

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“…Troponin augmentation among patients hospitalized with COVID-19 was associated with a higher risk of death [ 48 ]. Concerns related to the increased level of natriuretic peptides suggest its non-specificity, while the reported pulmonary embolism events should only be included in the appropriate clinical context [ 102 , 103 , 104 ].…”

Section: Cardiac Thrombotic Complicationmentioning

confidence: 99%

Thromboembolic Disease and Cardiac Thrombotic Complication in COVID-19: A Systematic Review

Nappi

Gambardella

et al. 2022

Metabolites

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The coronavirus 2019 pandemic has affected many healthcare systems worldwide. While acute respiratory distress syndrome (ARDS) has been well-documented in COVID-19, there are several cardiovascular complications, such as myocardial infarction, ischaemic stroke, and pulmonary embolism, leading to disability and death. The link between COVID-19 and increasing thrombogenicity potentially occurs due to numerous different metabolic mechanisms, ranging from endothelial damage for direct virus infection, associated excessive formation of neutrophil extracellular traps (NETs), pathogenic activation of the renin-angiotensin-aldosterone system (RAAS), direct myocardial injury, and ischemia induced by respiratory failure, all of which have measurable biomarkers. A search was performed by interrogating three databases (MEDLINE; MEDLINE In-Process and Other Non-Indexed Citations, and EMBASE). Evidence from randomized controlled trials (RCT), prospective series, meta-analyses, and unmatched observational studies were evaluated for the processing of the algorithm and treatment of thromboembolic disease and cardiac thrombotic complications related to COVID-19 during SARS-CoV-2 infection. Studies out with the SARS-Cov-2 infection period and case reports were excluded. A total of 58 studies were included in this analysis. The role of the acute inflammatory response in the propagation of the systemic inflammatory sequelae of the disease plays a major part in determining thromboembolic disease and cardiac thrombotic complication in COVID-19. Some of the mechanisms of activation of these pathways, alongside the involved biomarkers noted in previous studies, are highlighted. Inflammatory response led to thromboembolic disease and cardiac thrombotic complications in COVID-19. NETs play a pivotal role in the pathogenesis of the inflammatory response. Despite moving into the endemic phase of the disease in most countries, thromboembolic complications in COVID-19 remain an entity that substantially impacts the health care system, with long-term effects that remain uncertain. Continuous monitoring and research are required.

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Multisystem inflammatory syndrome in children: Inputs of BNP, NT-proBNP and Galectin-3

Cited by 4 publications

References 16 publications

Cardiac Involvement in Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) in Poland

Cardiac Involvement in Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) in Poland

NT-proBNP cardiac value in COVID-19: a focus on the paediatric population

Thromboembolic Disease and Cardiac Thrombotic Complication in COVID-19: A Systematic Review

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