The diagnostic value of plasma N-terminal connective tissue growth factor levels in children with heart failure

Objective The aim of this study was to assess the diagnostic value of plasma N-terminal connective tissue growth factor in children with heart failure. Methods and results Plasma N-terminal connective tissue growth factor was determined in 61 children, including 41 children with heart failure, 20 children without heart failure, and 30 healthy volunteers. The correlations between plasma N-terminal connective tissue growth factor levels and clinical parameters were investigated. Moreover, the diagnostic value of N-terminal connective tissue growth factor levels was evaluated. Compared with healthy volunteers and children without heart failure, plasma N-terminal connective tissue growth factor levels were significantly elevated in those with heart failure (p<0.01). N-terminal pro-brain natriuretic peptide and left ventricular end-diastolic dimension were positively correlated with plasma N-terminal connective tissue growth factor levels (r=0.364, p=0.006; r=0.308, p=0.016), whereas there was a negative correlation between left ventricular ejection fraction and plasma N-terminal connective tissue growth factor (r=−0.353, p=0.005). Connective tissue growth factor was significantly correlated with the severity of heart failure (p<0.001). Moreover, addition of connective tissue growth factor to N-terminal pro-brain natriuretic peptide did not significantly increase area under curve for diagnosing heart failure (area under curve difference 0.031, p>0.05), but it obviously improved the ability of diagnosing heart failure in children, as demonstrated by the integrated discrimination improvement (6.2%, p=0.013) and net re-classification improvement (13.2%, p=0.017) indices. Conclusions Plasma N-terminal connective tissue growth factor is a promising diagnostic biomarker for heart failure in children.