Current applications and future needs for biomarkers in pediatric cardiomyopathy and heart failure: Summary from the Second International Conference on Pediatric Cardiomyopathy

Biomarkers have established an important role in the diagnosis and prognosis of heart failure in adults, with early indications being that their sensitivity and specificity will be similar in the pediatric population. Since early detection of remodeling is vital to preemptive management in cardiomyopathy and in heart disease arising from congenital lesions, biomarkers may offer a means of identifying high risk patients before they develop symptoms. Although in current use, natriuretic peptides high sensitivity troponins, and C-reactive protein need to have their applications more clearly defined in pediatrics, by evidence based guidelines. Exploratory work should meanwhile continue to define the risk of disease progression in patients with dilated cardiomyopathy, and of sudden death in hypertrophic cardiomyopathy based on biomarker profiles. Further research into the interaction of the genetic basis of disease and proteomic biomarkers will be a valuable means of assessing the importance of different pathways of disease related ventricular remodeling.