Melatonin May Be Associated With Left Ventricular Diastolic Dysfunction in Pediatric Patients With Heart Failure

DOI: https://doi.org/10.21203/rs.3.rs-480877/v1

Abstract

Background

Melatonin has a protective role in adults with cardiovascular diseases. Diastolic dysfunction has been less well investigated in pediatric heart disease, and the effects of melatonin on cardiac diastolic dysfunction in children are not well understood. This study was designed to explore whether diastolic dysfunction is associated with the serum levels of melatonin or NO in children suffering from heart failure (HF) due to different etiology.

Methods

forty-seven pediatric patients with HF were enrolled in this study. Echocardiographic parameters were employed to evaluate the cardiac diastolic dysfunction. Diurnal serum levels of melatonin and NO were measured and analyzed in all pediatric patients.

Results

Diurnal serum melatonin levels were positively correlated with mitral valve E:A ratio (E/A) in children with HF (P=0.044), especially in children with HF due to cardiomyopathy (P=0.023). Moreover, serum melatonin levels showed significant positive correlation with E/A ratio in children with deteriorate diastolic dysfunction when employing E/A < 1 or > 2 as an indicator (P=0.012), and especially in children with HF due to cardiomyopathy (P=0.0014). Serum melatonin levels demonstrated significant positive correlation with mitral regurgitation (MR) jet area (P =0.005) and showed significant negative correlation with pulmonary valve regurgitation (PVR) velocity (P =0.009). In addition, serum NO levels were positively correlated with isovolumetric relaxation time (IRT) in children with HF(P=0.0047). Furthermore, the optimal cutoff value of serum melatonin levels for diagnosis for predicting E/A>2 in pediatric patients with HF was 84 pg/mL.

Conclusions

Diurnal serum melatonin and NO levels may be associated with left ventricular diastolic dysfunction in pediatric HF especially due to cardiomyopathy.

Full Text

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What Is Known

It is well known that biomolecules like melatonin can be increased in response to diseases, almost like an adaptive/compensatory response to the disease. It had shown a causal role for melatonin in the pathogenesis of HF.

What is new

So far, there is little known about the relationship between melatonin and diastolic dysfunction in children with HF. We are the first to evaluate the relative contributions of serum melatonin levels in severe cardiac diastolic dysfunction in juveniles.

List Of Abbreviations

AUC area under the ROC curve

EF ejection fraction

HF heart failure

INR isovolumetric relaxation time

MR mitral regurgitation

NO nitric oxide

NPV negative predictive value

PPV positive predictive value

SF shortening fraction

Declarations

FundingNo funding was received.

Conflicts of interest/Competing interestsAll authors declare that they have no conflict of interest and financial relationship with the organization that sponsored the research.

Availability of data and material: The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

Code availability: Not applicable.

Authors' contributions: Yao Wu: Conceptualization, Writing -original manuscript, Investigation, Writing -review and editing, Software, Formal analysis. Qijian Yi: Supervision, Conceptualization, Writing -review& editing.

Ethics approval: This research was approved by the ethics committee of Children’s Hospital of Chongqing Medical University.

Consent to participate: All patient derived blood samples were collected after written informed consent was obtained from parents or guardians.

Consent for publication: Written informed consent for publication was obtained from all participants.