Background:
Heart failure is one of the cardiovascular diseases that have high mortality and morbidity, especially in children. Early
diagnosis of HF is crucial for early management and for improving risk stratification for death from HF.Cardiac Myosin
Binding Protein C is a cardiomyocyte-specific sarcomeric protein, which regulates both sarcomeric structure and
function. It is easily soluble and releasable from the sarcomere. Moreover, the large size of it and its release into the
circulation inresponse tocardiac injurymakes it one of the promising cardiac biomarkers for detection of cardiac injury.
As 87% of new onset case of heart failure reach the diagnosis when the patient reaches the state of sever
decompensation.
Theaim of this study was to investigate the clinical value of Cardiac Myosin Binding Protein C level as a diagnostic and
prognostic biomarker in Pediatric Heart Failure.
Methods:
This was a comparative cross sectional study which was done on 2 groups;
Group I (study group) cases with acute heart failure, were collected from Pediatric ICU at Banha university Hospital, at
time of admission and group II (Control group) which comprised healthychild, age and sex matched with patients in
group I.
Results:
Our study showed the Echocardiographic diagnosis, VSD (33.3%) & Dilated cardiomyopathy (23.3%) were the most
predominant echocardiography among our cases. Mean value of LVEDD was statistically significant higher among
cases group than control group. Mean value of LVESD was statistically significanthigher among cases group than
control group. Mean value of FS% was statistically significant lower among cases group than control group. Mean
value of EF% was statistically significant lower among cases group than control group. The current study showed that
mean value of hemoglobin (Hb) was statistically significant lower among cases group than control group. This study
showed that, mean value of WBCs was lower among cases than controls. There was no statistically significant
difference between cases group and control group regarding CRP. The present study revealed that mean value of
Cardiac Myosin binding protein was statistically significanthigher among cases group with the mean (78.28± 34.38
ng/dl) than control group. Regarding Modified ROSS among cases group, percentage of patients with class II was
(13.3%), III and IV were (43.3%) each. This study showed that, the percentage of died was (13.3%) and discharged was
(86.7%)among cases group. In our study, there was negative statistically significant correlation between Cardiac
Myosin binding protein and EF% and FS%.This study showed that, Cardiac Myosin Binding Protein C level was
directly proportional to the severity of heart failure (Modified ROSS) and the severity of pulmonary hypertension as
well.The recent study showed that mean value of Cardiac Myosin binding protein C was statisticallysignificant higher
among died than discharged. Regarding Diagnostic accuracy of Cardiac Myosin binding protein, Sensitivity was 95%,
Specificity was 89%, PPV was 93.1%, NPV was 88.3% and accuracy was 90%.
Conclusion:
The results obtained in our study revealed that Myosin Binding Protein C is useful as a diagnostic and prognostic
biomarker in Pediatric Heart Failure.
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