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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Independent prognostic value of lipocalin-2 in congenital heart disease-associated pulmonary artery hypertension
Zhang-Ke Guo, Ping-Gui Chen, Yao-Xuan Li, Hong Jiao, Xiao-Hui Kong, Song Bai, Xiao-Feng Li, Ai-Jun Liu, Guo-Liang Wang
Zhang-Ke Guo, Song Bai, Xiao-Feng Li, Department of Cardiac Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Ping-Gui Chen, Department of General Surgery, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
Yao-Xuan Li, Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Hong Jiao, Xiao-Hui Kong, Guo-Liang Wang, Department of Tumor and Immunology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Ai-Jun Liu, Department of Pediatric Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China
Co-corresponding authors: Guo-Liang Wang and Ai-Jun Liu.
Author contributions: Wang GL and Liu AJ conceptualized and designed the research; Guo ZK, Bai S and Li XF screened patients and acquired clinical data; Wang GL, Guo ZK, Chen PG, Jiao H and Kong XH performed data curation, visualization, and interpretation; Wang GL, Li YX and Liu AJ wrote the manuscript; Wang GL and Liu AJ performed reviewing and final editing; All authors have read and agreed to the published version of the manuscript. Both Wang GL and Liu AJ have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors. Wang GL conceptualized, designed, and supervised the project, including literature collection, manuscript submission and revision, with a focus on the association between lipocalin-2 concentration and risk for pulmonary arterial hypertension. Liu AJ played a crucial role in data re-analysis and re-interpretation, figure plotting, comprehensive literature searching, and preparing the final manuscript submission, focusing specifically on the diagnostic value of lipocalin-2 in PAH. The collaboration between Wang GL and Liu AJ was essential to the publication of this manuscript.
Supported by the Scientific Achievements Transformation Incubation Fund of Beijing Children's Hospital, No. ZHFY3-1-015.
Institutional review board statement: This study was approved by Beijing Children’s Hospital Ethics Committee, No. 2022-E-083-Y. This study was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent statement: All patients or their parents (or legal guardians) provided written informed consent.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Guo-Liang Wang, PhD, Research Scientist, Researcher, Department of Tumor and Immunology, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nanlishi Road, Xicheng District, Beijing 100045, China.
wgl163@126.com
Received: April 8, 2024
Revised: September 14, 2024
Accepted: October 22, 2024
Published online: December 26, 2024
Processing time: 232 Days and 4.9 Hours
BACKGROUND
Timely and accurate evaluation of the patient's pulmonary arterial pressure (PAP) is of great significance for the treatment of congenital heart disease. Currently, there is no non-invasive gold standard method for evaluating PAP.
AIM
To assess the prognostic value of lipocalin-2 (LCN2) in relation to PAP in patients with congenital heart disease associated with pulmonary artery hypertension.
METHODS
We conducted a retrospective analysis of 69 pediatric patients diagnosed with ventricular septal defects. The patients’ clinical and laboratory data were collected. The serum LCN2 concentrations were compared between the pulmonary arterial hypertension (PAH) group and the nonPAH group. The correlation of LCN2 concentration with PAH classification was evaluated using binary logistic regression analysis. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic potential of LCN2 for PAH.
RESULTS
Serum LCN2 concentration significantly correlated with patients’ mean PAP (r = 0.544, P < 0.001), but not correlated with creatinine (P = 0.446) or blood urea nitrogen (P = 0.747). LCN2 levels were significantly correlated with PAH in both univariate [odds ratio (OR) 1.107, 95%CI: 1.033-1.185, P = 0.004)] and multivariate regression analysis (OR 1.150, 95%CI: 1.027-1.288, P = 0.015). ROC curve analysis revealed an area under the curve of 0.783 for LCN2. At the cutoff value of 19.42 ng/mL, the sensitivity and specificity of LCN2 for diagnosing PAH is 90.19% and 55.56%, respectively. LCN2 concentration also significantly correlated with the post-repair mean PAP in patients with congenital heart disease (r = 0.532, P = 0.009).
CONCLUSION
LCN2 is emerging as a candidate biomarker for assessing PAP in patients with congenital heart disease. Its high sensitivity in diagnosing PAH makes it a valuable tool in patient management.
Core Tip: This retrospective study demonstrates that lipocalin-2 (LCN2) blood levels significantly correlated with the mean pulmonary arterial pressure of patients with congenital heart disease (CHD). In particular, LCN2 was significantly correlated with the post-repair mean pulmonary arterial pressure of CHD patients. LCN2 has emerged as a candidate biomarker for CHD, and its high sensitivity to pulmonary arterial hypertension diagnosis makes it highly valuable in patient management.
