Prognostic Value of Serum Apelin Level in Children with Heart Failure Secondary to Congenital Heart Disease

Apelin is an endogenous inotrope that decreased in heart failure (HF). We aimed to evaluate the prognostic value of its level in children with HF due to congenital heart disease (CHD). Sixty children with HF due to CHD were included as a patient group. Sixty healthy children matched for age, sex, and weight served as a control group. Chest X-ray, electrocardiogram (ECG), echocardiography, and laboratory investigations such as complete blood count, c-reactive protein, and serum apelin levels were performed for all included children at admission. All children were followed up for 3 months. Serum apelin level was significantly decreased in patients with HF at admission than healthy control group and this decrease went with advanced stage of HF. Serum apelin levels were significantly decreased in patients with unfavorable prognosis than those with favorable prognosis. At a cutoff lower than 126 ng/l, the sensitivity of serum apelin to predict unfavorable prognosis in children with HF was 96% with a specificity of 82%. Serum apelin level had a significant positive correlation with left ventricular systolic function (P < 0.05). Moreover, it had a significant negative correlation with heart rate, respiratory rate, Ross classification, c-reactive protein, cardiothoracic ratio, and both left and right ventricular dimensions (P < 0.05). Serum apelin level has a good predictive value for adverse outcome in children with HF due to CHD.