Role of Biomarkers in the Early Detection of Heart Failure in Children

Abstract

Pediatric heart failure (HF) remains a major cause of morbidity and mortality and often presents with nonspecific clinical manifestations, making timely diagnosis and management challenging. Early detection is critical to prevent irreversible myocardial damage and to initiate appropriate therapeutic interventions. In recent years, the identification and validation of cardiac biomarkers have significantly advanced the diagnosis and prognostic evaluation of pediatric heart failure. This study aims to provide a comprehensive overview of key biomarkers used for the early detection and monitoring of heart failure in children. An extensive review of recent literature was conducted to evaluate diagnostic, prognostic, and inflammatory biomarkers associated with pediatric HF. Established biomarkers such as natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP), along with cardiac troponins (cTnI and cTnT), demonstrate strong diagnostic and prognostic value by reflecting myocardial stress and injury. Emerging biomarkers, including Galectin-3, Growth Differentiation Factor-15 (GDF-15), and myeloperoxidase (MPO), provide additional insights into underlying pathophysiological mechanisms such as inflammation, oxidative stress, and myocardial fibrosis. The combined use of multiple biomarkers enhances diagnostic sensitivity and supports effective therapy monitoring. Incorporating biomarker profiling into clinical practice improves early diagnosis, risk stratification, and treatment monitoring in pediatric heart failure. Future research should focus on integrating biomarker data with advanced imaging modalities and machine learning approaches to improve diagnostic accuracy and facilitate personalized treatment strategies for children with heart failure.