Plasma Connective Tissue Growth Factor Levels in Pediatric Patients with Pulmonary Hypertension Secondary to Congenital Heart Disease

Introduction Accurate measurement of pulmonary artery pressure traditionally involves catheterization, but due to its invasive nature, ongoing research is exploring biomarkers to assess pulmonary hypertension severity without resorting to procedures. This study aimed to investigate the association of plasma connective tissue growth factor (CTGF) levels with pulmonary hypertension secondary to congenital heart disease (PAH-CHD) in pediatrics. Methods This observational case-control study took placed at Shahid Modarres Educational Hospital in Tehran, Iran. The case group comprised 160 patients with congenital heart defects, evenly split between those with and without pulmonary hypertension. The control group included 80 healthy children matched for age and gender, and CTGF levels, SPO2, PASP, PADP, RVSP, RVDP, Qp/Qs, Rp were compared between the case and control groups. Results CTGF levels were significantly elevated in patients with congenital heart defects associated with pulmonary hypertension compared to both the control group (P-value = 0.024(and the congenital heart defect without pulmonary hypertension group (P-value = 0.002). In our study, a significant correlation and regression between CTGF levels and systolic pulmonary arterial pressure (PAP) (r = 0.286, P < 0.001 and β = 0.510, P = 0.008) was shown. However, no significant correlation or regression was observed between CTGF levels and diastolic PAP (r = 0.146, P = 0.066 and β=-0.096, P = 0.592), RVSP (r = 0.107, P = 0.179 and β=-0.013, P = 0.920), RVDP(r = 0.011, P = 0.894 and β = 0.035, P = 0.777), pulmonary flow to systemic flow (QP/QS) (r = 0.086, P = 0.278 and β = 0.055, P = 0.657), pulmonary resistance to systemic resistance (Rp/Rs) (r=-0.054, P = 0.495 and β = 0.013, P = 0.912) as well as IUCU stay (r = 0.146, P = 0.441 and β = 0.093, P = 0.461) and SPO2 (r = 0.048, P = 0.546 and β = 0.071, P = 0.587) Conclusion : This study underscores CTGF as a promising biomarker for assessing pulmonary hypertension in pediatric patients. Studies with prospective design are needed to further examine this association.