Evolving Proteomic Biomarkers in Children with Congenital Heart Defects

Conventional biomarkers provide useful information but often lack specificity due to age-related physiological variations or in the context of congenital heart disease (CHD). Proteomics uses new technologies to analyze hundreds to thousands of proteins simultaneously (multi-biomarker panels) and, combined with traditional ones (i.e., NT-BNP), it improves risk prediction and helps clinical decision making. In adults, there are clear efforts to improve risk prediction accuracy and personalized HF management strategies; meanwhile, more evidence must be established in the pediatric CHD population. This non-systematic review aims to give an overview of the limitations of conventional biomarkers and recently published literature on promising evolving biomarkers of the proteomic family that are applicable to the CHD population. Due to the highly complex physiology and interpretation of the anatomical variation of the biomarkers, it seems to be necessary for single markers to be tested in the pediatric population with various CHD anatomies and physiologies. Disease-specific validation is required, rather than assuming they behave the same way as they do in structurally normal hearts and adults.