NPPB and heart failure: In summary, the levels of Tim-3, NT proBNP, and sestrin2 in peripheral blood would be increased and LVEF and LVFS would be decreased in children with the left-to-right shunt congenital heart disease and heart failure, and the levels of Tim-3, NT proBNP and sestrin2 would have a better diagnostic value of left-to-right shunt congenital heart disease.