, Zülal Ülger Tutar 1
, Eser Doğan 1
, Meral Yılmaz 1
, Burcu Büşra Acar 1
, Hakan Kurt 1
, Burcugül Karasulu Beci 1
, Aslı Taşdemir 2
, Pınar Yazıcı 3
, Kübra Cebeci 3
, Hür Hassoy 4
, Ertürk Levent 1
, Osman Nuri Tuncer 5
, Çağatay Engin 5
, Tahir Yağdı 5
, Mustafa Özbaran 5
2Department of Pediatrics, Ege University Faculty of Medicine, İzmir, Türkiye
3Department of Pediatric Intensive Care, Ege University Faculty of Medicine, İzmir, Türkiye
4Department of Public Health, Ege University Faculty of Medicine, İzmir, Türkiye
5Department of Cardiovascular Surgery, Ege University Faculty of Medicine, İzmir, Türkiye
Abstract
Objective: Cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are key biomarkers reflecting myocardial injury and hemodynamic load in heart failure or after cardiac surgery. However, data on their postoperative course in pediatric HeartMate 3 (HM3) recipients are limited. This retrospective case series of ten pediatric patients aimed to evaluate the clinical significance of postoperative changes in these biomarkers.
Methods: This retrospective case series included pediatric patients who underwent left ventricular assist device (LVAD) implantation between 2022 and 2024 at the center. Clinical and laboratory data were retrospectively obtained from medical records.
Results: Ten patients with dilated cardiomyopathy (PEDIMACS profiles 1-3) were included. The median preoperative cTnT level was 98.5 [IQR 42.5-236.5] ng/L. Median postoperative cTnT levels were 182.6 [IQR 88.3-342.9] ng/L at 1 month, 54.0 [IQR 32.0-92.0] ng/L at 6 months, and 43.2 [IQR 25.8-71.4] ng/L at 12 months. Median B-type natriuretic peptide (BNP) levels were 7510 [IQR 5350-10850] ng/L preoperatively, 4122 [IQR 2963-7288] ng/L at 1 month, 853 [IQR 520.3-1426] ng/L at 6 months, and 1041 [IQR 619.8-1524] ng/L at 12 months. The mean intensive care unit (ICU) stay was 24.1 ± 16.3 days. Troponin levels returned to normal by postoperative month 6 in all but 2 patients. Spearman analysis showed a significant positive correlation between preoperative cTnT and ICU stay
(ρ = 0.687, P = .028).
Conclusion: In pediatric HM3 recipients, cTnT and NT-proBNP levels reflect postoperative myocardial recovery and may serve as clinically useful indicators associated with intensive care duration.