Anne-Marie Koop

8 287 Biomarker plasma levels in relation to RV remodelling and function In the total study population, 51 children showed RVH with echocardiography, whereas 71 children did not. In three children RVH could not be assessed due to insufficient quality of the images. Plasma levels of hsTnT, NT-proBNP, MR-proADM, GDF-15, MPO and ET-1 were increased in children with RVH compared to those without RVH ( figure 2a ). The predictive value of these six biomarkers were expressed by ROC curves and revealed the following cut-off values and max area under the curve (AUC): NT-proBNP 147 ng/L (AUC 0.76, p<0.001; sensitivity 64% and specificity 78%), ET-1 1.36 pg/ml (AUC 0.74, p<0.001; sensitivity 80% and specificity 58%), hsTnT 5.5 ng/l (AUC 0.62, p=0.031; sensitivity 50% and specificity 69%), MR-proADM 0.448 nmol/l (AUC 0.65, p=0.006; sensitivity 45% and specificity 89%), GDF- 15 321 pg/ml (AUC 0.67, p=0.002; sensitivity 82% and specificity 49%), and MPO 37.5 ng/ml (AUC 0.68, p=0.002; sensitivity 49% and specificity 83%). Echocardiographic assessment showed 73 children to have RV dilatation, whereas 49 children did not. In three children RV dilatation could not be assessed. Biomarker plasma levels did not differ significantly between children with and without RV dilatation ( figure 2b ). Echocardiographic assessment revealed a good systolic RV function (eyeballing) in 86% of the children, a moderate systolic RV function in 12% and poor systolic RV function in 2%. The median (IQR) z-score TAPSE was -2.1 (-3.8 to -0.5).29 Stratification for type of RV overload is shown in table 1. RV function did not differ between groups. Although none of the biomarkers levels showed a correlation with subjective assessment of systolic RV function ( figure 2c ), Spearman correlation analysis of the eight biomarkers revealed NT-proBNP to correlate inversely with RV function expressed as TAPSE ( table 3 ). Plasma levels of hsTnT, NT- proBNP, MR-proADM, GDF-15, MPO and ET-1 are associatedwith right ventricular hypertrophy in children with increased right ventricular pressure load.