Acute Cardiovascular Manifestations in 286 Children With Multisystem Inflammatory Syndrome Associated With COVID-19 Infection in Europe

Background: The aim of the study was to document cardiovascular clinical findings, cardiac imaging, and laboratory markers in children presenting with the novel multisystem inflammatory syndrome associated with coronavirus disease 2019 (COVID-19) infection. Methods: This real-time internet-based survey has been endorsed by the Association for European Paediatric and Congenital Cardiologists Working Groups for Cardiac Imaging and Cardiovascular Intensive Care. Children 0 to 18 years of age admitted to a hospital between February 1 and June 6, 2020, with a diagnosis of an inflammatory syndrome and acute cardiovascular complications were included. Results: A total of 286 children from 55 centers in 17 European countries were included. The median age was 8.4 years (interquartile range, 3.8–12.4 years) and 67% were boys. The most common cardiovascular complications were shock, cardiac arrhythmias, pericardial effusion, and coronary artery dilatation. Reduced left ventricular ejection fraction was present in over half of the patients, and a vast majority of children had raised cardiac troponin when checked. The biochemical markers of inflammation were raised in most patients on admission: elevated C-reactive protein, serum ferritin, procalcitonin, N-terminal pro B-type natriuretic peptide, interleukin-6 level, and D-dimers. There was a statistically significant correlation between degree of elevation in cardiac and biochemical parameters and the need for intensive care support ( P <0.05). Polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 was positive in 33.6%, whereas immunoglobulin M and immunoglobulin G antibodies were positive in 15.7% cases and immunoglobulin G in 43.6% cases, respectively, when checked. One child in the study cohort died. Conclusions: Cardiac involvement is common in children with multisystem inflammatory syndrome associated with the Covid-19 pandemic. The majority of children have significantly raised levels of N-terminal pro B-type natriuretic peptide, ferritin, D-dimers, and cardiac troponin in addition to high C-reactive protein and procalcitonin levels. In comparison with adults with COVID-19, mortality in children with multisystem inflammatory syndrome associated with COVID-19 is uncommon despite multisystem involvement, very elevated inflammatory markers, and the need for intensive care support.

Download Full-text

Faculty Opinions recommendation of Simultaneous measurement of cardiac troponin I, B-type natriuretic peptide, and C-reactive protein for the prediction of long-term cardiac outcome after cardiac surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1163593.625346 ◽

2009 ◽

Author(s):

Girish Joshi ◽

Peter Hession

Keyword(s):

Cardiac Surgery ◽

Natriuretic Peptide ◽

Simultaneous Measurement ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

C Reactive Protein ◽

Reactive Protein ◽

Cardiac Outcome

Download Full-text

Multiplex Detection of B-Type Natriuretic Peptide, Cardiac Troponin I and C-Reactive Protein with Photonic Suspension Array

PLoS ONE ◽

10.1371/journal.pone.0041448 ◽

2012 ◽

Vol 7 (7) ◽

pp. e41448 ◽

Cited By ~ 5

Author(s):

Wenbin Lu ◽

Cong Fu ◽

Yong Chen ◽

Jun Lu ◽

Yuyu Yao ◽

...

Keyword(s):

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

Multiplex Detection ◽

C Reactive Protein ◽

Suspension Array ◽

Reactive Protein

Download Full-text

NT-proBNP, hs-cTnT, and CRP predict the risk of cardiopulmonary outcomes in systemic sclerosis: Findings from the Canadian Scleroderma Research Group

Journal of Scleroderma and Related Disorders ◽

10.1177/23971983211040608 ◽

2021 ◽

pp. 239719832110406

Author(s):

Mayank Jha ◽

Mianbo Wang ◽

Russell Steele ◽

Murray Baron ◽

Marvin J Fritzler ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Systemic Sclerosis ◽

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin T ◽

High Sensitivity ◽

Cardiac Troponin T ◽

C Reactive Protein ◽

Reactive Protein ◽

Increased Risk

Objective: The aim of this study was to determine the independent value of N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein to predict onset of cardiopulmonary disease in a large, multi-center systemic sclerosis cohort followed prospectively. Methods: Subjects from the Canadian Scleroderma Research Group registry with data on N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein were identified. Outcomes of interest were death, systolic dysfunction (left ventricular ejection fraction < 50% or medications for heart failure), pulmonary arterial hypertension by right heart catheterization, pulmonary hypertension by cardiac echocardiography (systolic pulmonary artery pressures ⩾ 45 mmHg), arrhythmias (pacemaker/implantable cardiac defibrillator or anti-arrhythmic medications), and interstitial lung disease. Multivariate Cox proportional hazard models were generated for each outcome. Results: A total of 675 subjects were included with a mean follow-up of 3.0 ± 1.8 years. Subjects were predominantly women (88.4%) with mean age of 58.2 ± 11.3 years and mean disease duration of 13.7 ± 9.1 years. One hundred and one (101, 15%) subjects died during follow-up, 37 (6.4 %) developed systolic dysfunction, 18 (2.9%) arrhythmias, 34 (5.1%) pulmonary arterial hypertension, 43 (7.3%) pulmonary hypertension, and 48 (12.3%) interstitial lung disease. In multivariate analyses, elevated levels of N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein were associated with increased risk of death, while elevated levels of N-terminal pro b-type natriuretic peptide and C-reactive protein were associated with increased risk of developing pulmonary hypertension. Conclusion: In systemic sclerosis, N-terminal pro b-type natriuretic peptide, high-sensitivity cardiac troponin T, and C-reactive protein have independent predictive value for death and pulmonary hypertension. A larger study would be required to determine the predictive value of these biomarkers for less common systemic sclerosis outcomes.

Download Full-text

Procalcitonin (PCT), C-reactive protein (CRP), cardiac troponin I (TNI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and prognosis in infective endocarditis

Clinica Chimica Acta ◽

10.1016/j.cca.2019.03.365 ◽

2019 ◽

Vol 493 ◽

pp. S175

Author(s):

A. Bugrov ◽

A. Roitman ◽

L. Beganskaya ◽

T. Fedorova ◽

V. Dolgov

Keyword(s):

Infective Endocarditis ◽

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

C Reactive Protein ◽

Reactive Protein

Download Full-text

C-Reactive Protein Alone or Combined With Cardiac Troponin T for Risk Stratification of Respiratory Intensive Care Unit Patients

Respiratory Care ◽

10.4187/respcare.01007 ◽

2011 ◽

Vol 56 (7) ◽

pp. 1002-1008 ◽

Cited By ~ 5

Author(s):

S. Ozsu ◽

G. Yilmaz ◽

I. Yilmaz ◽

F. Oztuna ◽

Y. Bulbul ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Risk Stratification ◽

Cardiac Troponin ◽

Troponin T ◽

Cardiac Troponin T ◽

C Reactive Protein ◽

Reactive Protein ◽

Respiratory Intensive Care Unit

Download Full-text

Correlations of Changes in Brain Natriuretic Peptide (BNP) and Cardiac Troponin I (cTnI) with Levels of C-Reactive Protein (CRP) and TNF-α in Pediatric Patients with Sepsis

Medical Science Monitor ◽

10.12659/msm.912318 ◽

2019 ◽

Vol 25 ◽

pp. 2561-2566 ◽

Cited By ~ 1

Author(s):

Yue Zhang ◽

Ya Luo ◽

Gulibaihairenmu Nijiatijiang ◽

Kaiyishaer Balati ◽

Yaxiaer Tuerdi ◽

...

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Cardiac Troponin ◽

Pediatric Patients ◽

Troponin I ◽

Cardiac Troponin I ◽

C Reactive Protein ◽

Reactive Protein ◽

Tnf Α

Download Full-text

The role of biochemical markers as early indicators of cardiac damage and prognostic parameters of perinatal asphyxia

Vojnosanitetski pregled ◽

10.2298/vsp1402149s ◽

2014 ◽

Vol 71 (2) ◽

pp. 149-155 ◽

Cited By ~ 2

Author(s):

Aleksandra Simovic ◽

Jovan Kosutic ◽

Sergej Prijic ◽

Jasmina Knezevic ◽

Ana Vujic ◽

...

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Perinatal Asphyxia ◽

Cardiac Troponin I ◽

Full Term ◽

C Reactive Protein ◽

Reactive Protein ◽

Term Newborns

Background/Aim. In recent years, the focus of interest of the scientific community is the application of heart markers as early indicators and prognostic parameters of perinatal asphyxia (PA). The aim of this study was to evaluate the significance of clinical application of heart markers in term newborns with perinatal asphyxia. Methods. During a 3- year period we analyzed 91 full-term newborns (55 with and 36 without perinatal asphyxia). In all the subjects within the first 24-48 h after birth, we simultaneously determined serum concentrations of cardiac troponin I, brain natriuretic peptide, MB fraction of creatine kinase (CK-MB) and Creactive protein. Results. In the group of full-term neonates with PA significantly higher levels of cardiac troponinI (p = 0.000), CK-MB fraction (p = 0.000), brain natriuretic peptide (p = 0.003) and C-reactive protein (p = 0.017) were found, compared to the group of healthy full-term newborns. In merged group (n = 91) cardiac troponin I level correlated with the fifth minute Apgar score (r = - 0.637, p = 0.000) and the serum lactate concentration in the first 12h after birth (r = 0.529, p = 0.000). Early increase in cardiac troponin I > 0.135 ?g/L predicted the risk of death with the sensitivity of 84.6% and specificity of 85.9%, while the increase in CK-MB fraction, brain natriuretic peptide and C-reactive protein did not have a predictive value with respect to a mortality outcome. Conclusion. Among the tested cardiac markers, cardiac troponin I is the most sensitive and the only reliable early predictor of mortality in fullterm neonates with perinatal asphyxia.

Download Full-text

Faculty of 1000 evaluation for Simultaneous measurement of cardiac troponin I, B-type natriuretic peptide, and C-reactive protein for the prediction of long-term cardiac outcome after cardiac surgery.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.1163593.1866054 ◽

2010 ◽

Author(s):

Yukio Hayashi

Keyword(s):

Cardiac Surgery ◽

Natriuretic Peptide ◽

Simultaneous Measurement ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

C Reactive Protein ◽

Reactive Protein ◽

Cardiac Outcome

Download Full-text

Simultaneous Measurement of Cardiac Troponin I, B-type Natriuretic Peptide, and C-reactive Protein for the Prediction of Long-term Cardiac Outcome after Cardiac Surgery

Anesthesiology ◽

10.1097/aln.0b013e3181a1f720 ◽

2009 ◽

Vol 111 (2) ◽

pp. 250-257 ◽

Cited By ~ 22

Author(s):

Jean-Luc Fellahi ◽

Jean-Luc Hanouz ◽

Yannick Le Manach ◽

Xavier Gué ◽

Emmanuel Monier ◽

...

Keyword(s):

Cardiac Surgery ◽

Natriuretic Peptide ◽

Cardiac Troponin ◽

Troponin I ◽

Cardiac Troponin I ◽

Major Adverse Cardiac Events ◽

C Reactive Protein ◽

Cardiac Events ◽

Reactive Protein ◽

Adverse Cardiac Events

Background Simultaneous assessment of cardiac troponin I, B-type natriuretic peptide, and C-reactive protein has been found to provide unique prognostic information in acute coronary syndromes. The current study addressed the prognostic implication of a multiple-marker approach in cardiac surgery. Methods Two hundred twenty-four patients undergoing cardiac surgery were included and followed up within 12 months after surgery. Serial blood samples were drawn in all patients the day before surgery, at the end of surgery, and 6, 24, and 120 h after surgery. Major adverse cardiac events within 12 months after surgery were chosen as study endpoints and were defined as malignant ventricular arrhythmia, myocardial infarction, congestive heart failure, the need for myocardial revascularization, and/or death from cardiac cause. Predictive ability of each cardiac biomarker was assessed using logistic regression. Results Accuracies of C-reactive protein, cardiac troponin I, and B-type natriuretic peptide, considered as continuous variables, to predict the occurrence of major adverse cardiac events were limited (area under receiver operating characteristic curve: 0.54 [0.47-0.60], P = 0.42; 0.62 [0.55-0.68], P = 0.01; and 0.68 [0.61-0.74], P < 0.001, respectively). When biomarkers were considered as 75% specificity dichotomized variables, elevated C-reactive protein (> 180 mg/l), cardiac troponin I (> 3.5 ng/ml), and B-type natriuretic peptide (> 880 pg/ml) were independent predictors of major adverse cardiac events (odds ratio: 2.14 [1.03-4.49], P = 0.043; 2.37 [1.25-5.64], P = 0.011; and 2.65 [1.16-4.85], P = 0.018, respectively) in a multivariate model including the European System for Cardiac Operative Risk Evaluation score. Conclusions Simultaneous measurement of cardiac troponin I, B-type natriuretic peptide, and C-reactive protein improves the risk assessment of long-term adverse cardiac outcome after cardiac surgery.

Download Full-text