Análise dos biomarcadores e capacidade funcional em crianças e adolescentes com cardiopatia congênita e hipertensão pulmonar
Analysis of biomarkers and functional capacity in children and adolescents with congenital heart disease and pulmonary hypertension
Mariana Carvalho de Oliveira, Flávia Navarro, Maria Eduarda Malosá Jorge, Vitor Doria Ricardo, Luciana Maria Malosá Sampaio
Resumo
Introdução: Com o avanço no diagnóstico e intervenção houve um crescente aperfeiçoamento no manejo das cardiopatias congênitas (CC) e suas complicações. O curso natural do paciente com CC está associado a sequelas tardias, como a hipertensão arterial pulmonar (HAP). O tratamento de HAP infantil é baseado na estratificação do risco, com preditores de piores prognósticos semelhantes a adultos. Na população de CC com HAP poucos estudos correlacionam os preditores clínicos e laboratoriais à gravidade. Objetivo: Correlacionar a capacidade funcional com marcadores pré-estabelecidos na literatura de crianças e adolescentes com CC e HAP. Métodos: Estudo retrospectivo, com banco de dados de crianças e adolescentes com CC e HAP de um Ambulatório em São Paulo. Foram coletados dados clínicos, distância do teste de caminhada de 6 minutos (DTC6), classificação funcional da Organização Mundial de Saúde (WHO-FC) e exames laboratoriais. As variáveis epidemiológicas foram analisadas de acordo com a normalidade, além da utilização da correlação de Spearman e Pearson, quando aplicável. Resultados: A amostra foi composta por 25 pacientes, sendo 52% pacientes do sexo feminino, com média de idade de 15,1 anos (±1,25). A DTC6 predita foi 46,1% no grupo feminino e 46,7% no masculino (p= 0,180). A correlação entre a WHO-FC e TC6 foi muito fraca (r= 0,093) e entre WHO-FC e peptídeo natriurético tipo-B foi fraca (r= 0,346). Não houve diferença entre os grupos da WHO-FC em relação a DTC6 (p= 0,449). Conclusão: Não foi encontrada uma correlação forte entre a capacidade funcional dos pacientes e os biomarcadores utilizados para o acompanhamento da HAP.
Palavras-chave
Abstract
Background: With advances in diagnosis and intervention, there has been a growing improvement in the management of congenital heart disease (CHD) and its complications. The natural course of patients with CHD is associated with late sequelae, such as pulmonary arterial hypertension (PAH). The treatment of pediatric PAH is based on risk stratification, with predictors of poor prognosis similar to those in adults. In the CHD population with PAH, few studies have correlated clinical and laboratory predictors with disease severity. Aim: To correlate functional capacity with pre-established markers in the literature among children and adolescents with CHD and PAH. Methods: A retrospective study using a database of children and adolescents with CHD and PAH from an outpatient clinic in São Paulo. Clinical data, six-minute walk test distance (6MWD), World Health Organization functional class (WHO-FC), and laboratory tests were collected. Epidemiological variables were analyzed according to normality, and Spearman’s or Pearson’s correlation was applied when appropriate. Results: The sample consisted of 25 patients, 52% of whom were female, with a mean age of 15.1 years (±1.25). The predicted 6MWD was 46.1% in the female group and 46.7% in the male group (p= 0.180). The correlation between WHO-FC and 6MWD was very weak (r = 0.093), and between WHO-FC and B-type natriuretic peptide was weak (r = 0.346). No significant difference was found between WHO-FC groups in relation to 6MWD (p = 0.449). Conclusion: No strong correlation was found between the patients’ functional capacity and the biomarkers used for PAH follow-up.
Keywords
Referências
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Submetido em:
14/01/2025
Aceito em:
04/02/2026
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