Abstract P012: Cardiac Biomarkers of Newborn Myocardial Injury, Cardiomyopathy and Inflammation are Associated with Indicators of Premature Cardiovascular Disease in Childhood: The National Institutes of Health Project VIVA Study

Abstract

Objective: To examine associations of cord blood cardiac biomarker levels in normal newborns with cardiovascular outcomes and adiposity in childhood. Methods: Among a sample (N=49) from 1120 Project Viva pediatric participants, selected to be ∼1/3 white, 1/3 black, 1/3 Hispanic, and whose gestational age at birth was ≥34 wks, we examined relations of cord blood levels of cardiac troponin T (cTnT, a biomarker for myocyte injury), high sensitivity C-reactive protein (hsCRP, a generalized marker of systemic inflammation) & N-terminal pro-brain natriuretic peptide (NT-proBNP, a biomarker of LV pressure or volume overload, cardiomyopathy, cardiac neurohormonal activation) with child outcomes at ages 3 & 7 years. Results: Forty six percent (22 of 49) were female. Mean cTnT was 47.0 pg/mL (range=15.1-87.3 pg/mL; detection limit=10 pg/ml). Mean NT-proBNP was 663 pg/mL (range=166-2042 pg/mL; normal <150 pg/ml) and mean hsCRP was 0.07 mg/L (range=0.03-0.18 mg/L; normal <1mg/L). For each 100 pg/mL increase in NT-pro-BNP, the ratio of subscapular: triceps skinfolds (central fat distribution) at 3 yrs was slightly higher (0.98 [95% CI -0.20, 2.16], P=0.10) and fat mass/m2 (DXA) at 7 yrs was higher (0.18 [95% CI 0.03, 0.33], P=0.02). For each 0.1 mg/L increase in hsCRP, the heart rate was 8.7 beats per minute lower (95% CI -15.8, -1.6, P=0.02) at age 7 years. Conclusions: Biomarkers of cardiomyopathy, inflammation, and cardiac injury are commonly elevated at birth. In this pilot study, cardiomyopathy and inflammation biomarkers were associated with higher central fat distribution and fat mass and lower resting pulse rate up to 7 years later. Larger cohort studies are needed to further examine cardio-metabolic outcomes related to these cord blood cardiac biomarkers.