The following is the summary of “Diagnostic value of peripheral TiM-3, NT proBNP, and Sestrin2 testing in left-to-right shunt congenital heart disease with heart failure” published in the January 2023 issue of Pediatrics by Wang, et al.


Patients with left-to-right shunt congenital heart disease are at a higher risk for developing recurrent respiratory infections, which can further increase the severity of pulmonary hypertension and reduce cardiac function. Research into non-invasive diagnostic techniques that can reveal heart anatomy and related abnormalities is urgently needed in clinical practice. Patients with left-to-right shunt congenital heart disease and heart failure will be tested for peripheral mucin domain protein-3 (Tim-3), N-terminal pro-brain natriuretic peptide (NT proBNP), and sestrin2.

 Participants included 52 infants with left-to-right shunt congenital cardiac dysfunction and 30 infants without the defect. For the purpose of measuring TiM-3, NT proBNP, and Sestrin2 levels, neonates’ blood was drawn within the first 24 hours of admission. Understanding the diagnostic precision was made possible by examining the Receiver operating characteristic (ROC) curve. The results of a logistic regression analysis and a Spearman’s rank correlation test were compared. Circulating levels of TiM-3, NT proBNP, and Sestrin2 were significantly different amongst the 3 groups (P<0.05). When comparing (left ventricular ejection fraction) LVEF and left ventricular short axis shortening(LVFS) among the 3 groups, significant differences were found (P<0.05). TiM-3, NT proBNP, and Sestrin2, when used to identify heart failure in association with left-to-right shunt congenital heart disease, showed a sensitivity of 58.3%, 58.3%, and 83.3%, respectively, and a specificity of 85.0, 72.5, and 70.0%, respectively. 

Tim-3, NT proBNP, and sestrin2 all had AUCs of 0.744 (95% CI, 0.580 to 0.908), 0.608 (95% CI, 0.359 to 0.857), and 0.744 (95% CI, 0.592 to 0.896) when it came to predicting the outcome of left-to-right shunt congenital heart disease with heart failure, respectively. Heart failure can be distinguished from non-combined heart failure and left-to-right shunt congenital heart disease with high accuracy using Tim-3, NT proBNP, and sestrin2.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03823-z