Serum Cystatin C: A Potential Biomarker in Pediatric PAH

Cystatin C – a crucial marker of heart failure (HF), strongly correlates to right ventricle (RV) ejection fraction (EF). Therefore, it may also be useful in determining pulmonary arterial hypertension (PAH) among pediatric patients.

A new study evaluated the utility of cystatin C as a biomarker in the diagnosis and prognosis of PAH.

This study recruited 22 children with PAH and 19 matched controls from December 2017-May, 2018. Patients were investigated for their serum-ProBNP levels and cystatin C. Echocardiography was employed to detect – RV-EF, RV end-systolic volume, RV-Tei index, RV end-diastolic volume Tricuspid Annular Plane Systolic Excursion (TAPSE), and left ventricle (LV) eccentricity. 

The results showed that the serum-cystatin-C levels of PAH patients were higher than those of the controls. The primary PAH group showed greater Cystatin-C levels compared to the Eisenmenger syndrome and control groups. Meanwhile, PAH patients had lower RV-EF and TAPSE and higher LV eccentricity measurements. 

Children with PAH exhibit normal glomerular filtration rate (GFR) and high cystatin C levels. It was concluded that cystatin C could be a useful biomarker for specifying RV dysfunction in this group of patients, owing to its correlation with the RV Tei index. Cystatin C can be deemed as a potential new biomarker in PAH.

Source: Indian Journal of Pediatrics. 2023 Apr;90(4):417.