Cardiac biomarkers in HIV-exposed uninfected children.
Cardiac biomarkers in HIV-exposed uninfected children.
复制标题
DOI：
10.1097/qad.0b013e32835cf21c
复制
发表时间：
2013-04-24
期刊：
影响因子：
--
通讯作者：
Pediatric HIVAIDS Cohort Study (PHACS)
中科院分区：
文献类型：
--
作者：
Wilkinson JD;Williams PL;Leister E;Zeldow B;Shearer WT;Colan SD;Siberry GK;Dooley LB;Scott GB;Rich KC;Lipshultz SE;Pediatric HIVAIDS Cohort Study (PHACS)
评估hiv暴露但未感染（HEU）儿童心脏生物标志物与子宫内抗逆转录病毒（ARV）药物暴露和超声心动图测量的心脏功能/结构的关系。我们分析了三种心脏生物标志物（心肌肌钙蛋白T、cTnT、高敏c反应蛋白、hsCRP和n端脑利钠肽前体NT-proBNP）与产前ARV暴露、母婴特征和超声心动图参数的关系。在338名HEU儿童（平均年龄=4.3岁）中，51%至少有1项心脏生物标志物升高。母亲吸烟与NT-proBNP升高相关（校正优势比[aOR]=2.28， P=0.02）。母亲使用酒精和阿巴卡韦与cTnT水平升高相关（aOR=3.56， P=0.01和aOR=2.33， P=0.04）。在94名超声心动图-生物标志物配对测量的儿童中，cTnT测量与左心室（LV）厚度-尺寸比增加相关（r=0.21， P=0.04）；cTnT升高与左室舒张末期（ED）后壁平均厚度升高相关（P=0.04）。hsCRP测量值与室间隔厚度呈负相关（r=-0.22， P=0.03）， hsCRP升高与较低的平均左室收缩性z评分相关（P=0.04）。NT-proBNP测量与LVED维度增加相关（r=0.20， P=0.05）， NT-proBNP升高与收缩末间隔平均厚度降低相关（P=0.03）。我们的研究结果表明，心脏生物标志物可能有助于识别需要进一步心脏评估的HEU儿童，包括超声心动图。产前阿巴卡韦暴露对心脏的潜在影响需要进一步调查。
To evaluate associations of cardiac biomarkers with in utero antiretroviral (ARV) drug exposures and cardiac function/structure measured by echocardiograms in HIV-exposed but uninfected (HEU) children. 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 ARV exposures, maternal-child characteristics, and echocardiographic parameters. Among 338 HEU children (mean age=4.3 years), 51% had at least 1 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 (LV) thickness-to-dimension ratio (r=0.21, P=0.04); and elevated cTnT was associated with higher mean LV end-diastolic (ED) 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 LV 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). 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.