Molecular markers of cardiomyopathy in cyanotic pediatric heart disease

Cyanotic congenital heart disease (CHD) accounts for approximately 25% of all types of CHD, encompassing a variety of cardiac anomalies. Children with cyanotic CHD are at risk for heart failure, cardiomyopathy, and arrhythmias. In addition to the hemodynamic burden, recent data suggest that hypoxia may contribute to heart failure. Previous studies have shown that neonatal hypoxia results in significant myocardial gene expression alterations that persist in adulthood after the termination of the hypoxic stimulus in the neonatal period or early infancy. In this article we review the current knowledge on molecular biomarkers of cyanotic CHD pathobiology, and expand on how the current knowledge establishes the basis for future studies to further define the role of molecular tools in cyanotic CHD to improve diagnostic, prognostic and therapeutic strategies.