scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2: The Importance of Prompt Detection of Cardiovascular Involvement

2020 ◽  
Vol 14 (1) ◽  
pp. 38-41
Author(s):  
Osmar A. Centurión ◽  
Luís M. Miño ◽  
Karina E. Scavenius
Keyword(s):  
Troponin T ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Protein Levels ◽  
Reactive Protein ◽  
Appropriate Treatment ◽  
Cardiovascular Involvement ◽  
Positive Linear Correlation ◽  
Clinical Surveillance ◽  
Myocardial Involvement

Increased morbidity and mortality are associated with coronavirus disease 2019 (COVID-19) when there is cardiovascular (CV) involvement. Due to the absence of prospective, well-designed, controlled studies, the exact mechanism responsible for cardiac injury among patients with COVID-19 remains uncertain. However, possible mechanisms described in observational studies can be considered. Non-ischemic events and ischemic myocardial involvement are the two main pathophysiological mechanisms of acute cardiac injury in COVID-19 patients. Non-ischemic myocardial injury is probably predominant and is secondary to multiple pathological mechanisms. Cardiac involvement is relatively common among hospitalized patients with COVID-19 and is associated with a greater risk of in-hospital mortality and ventricular arrhythmias. There was also a high and significantly positive linear correlation between troponin T and plasma high-sensitivity C-reactive protein levels. It is important to promptly detect CV involvement to avoid increased mortality in these patients. These findings highlight the importance of clinical surveillance and laboratory testing of serum troponin levels to ensure appropriate early identification and proceed with appropriate treatment. This should apply to patients with/without prior CV involvement. There are several possible mechanisms of myocardial tissue damage and the exact mechanisms involved need to be explored in well-designed studies.

The role and efficacy of routine high-sensitivity troponin T screening in paediatric COVID-19

2022 ◽  
pp. 1-5
Author(s):  
Mehmet G. Ramoğlu ◽  
Selen Karagözlü ◽  
Özlem Bayram ◽  
Jeyhun Bakhtiyarzada ◽  
Alperen Aydın ◽  
...  
Keyword(s):  
Troponin T ◽  
Myocardial Dysfunction ◽  
High Sensitivity ◽  
Common Symptom ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
High Sensitivity Troponin ◽  
High Sensitivity Troponin T ◽  
Echocardiographic Findings

Abstract Objective: We aimed to evaluate the efficacy and role of high-sensitivity troponin T in children with a confirmed SARS-CoV-2 infection and also the correlation of troponin T levels with symptoms, and echocardiographic findings were analysed. Methods: Two hundred and fourteen patients with a confirmed SARS-CoV-2 infection between the dates of 28 March and 15 August 12020 were enrolled in this retrospective single-centre study. Patients with comorbidities and diagnosed as multisystem inflammatory syndrome in children were excluded. Demographic data, clinical and laboratory parameters were evaluated. The patients were classified and compared according to the troponin positivity. The correlation of troponin T with symptoms and echocardiographic findings was analysed. Results: The most common symptoms in the whole study group were fever (53.3%) and cough (24.8%). Troponin T levels were elevated in 15 (7%) patients. The most common symptom in patients with troponin positivity was also fever (73.3%). Troponin T positivity was significantly higher in patients under the age of 12 months and troponin T levels were negatively correlated with age. C-reactive protein levels were elevated in 77 (36%) of the patients in the whole group and 7 (46.7%) of 15 patients with troponin positivity. C-reactive protein levels were similar between groups. Conclusion: Routine troponin screening does not yield much information in previously healthy paediatric COVID-19 patients without any sign of myocardial dysfunction. Elevated troponin levels may be observed but it is mostly a sign of myocardial injury without detectable myocardial dysfunction in this group of patients.

High-Sensitivity C-Reactive Protein Levels Among Healthy Egyptian Elderly

2013 ◽  
Vol 61 (3) ◽  
pp. 458-459
Author(s):  
Moatassem S. Amer ◽  
Mohamed S. Khater ◽  
Randa A. Mabrouk ◽  
Hend M. Taha ◽  
Ahmed S. Mohammedin
Keyword(s):  
High Sensitivity ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

Obesity and Serum High Sensitivity C-Reactive Protein Levels Among Elderly Turkish Immigrants in the Netherlands with Type 2 Diabetes

2012 ◽  
Vol 39 (1) ◽  
pp. 68-80 ◽  
Author(s):  
Shiryn D. Sukhram ◽  
Gustavo G. Zarini ◽  
Lamya H. Shaban ◽  
Joan A. Vaccaro ◽  
Fatma G. Huffman
Keyword(s):  
Type 2 Diabetes ◽  
The Netherlands ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Turkish Immigrants ◽  
Protein Levels ◽  
Reactive Protein

Identification of macrotroponin T: findings from a case report and non-reproducible troponin T results

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Leo Lam ◽  
Leah Ha ◽  
Campbell Heron ◽  
Weldon Chiu ◽  
Campbell Kyle
Keyword(s):  
Troponin T ◽  
Protein A ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
High Molecular Weight Complex ◽  
High Incidence ◽  
Laboratory Results ◽  
Clinical Consequences ◽  
Very High ◽  
Biochemical Features

Abstract Objectives Macrotroponin is due to cardiac troponin (cTn) binding to endogenous cTn autoantibodies. While previous studies showed a high incidence of macrotroponin affecting cTnI assays, reports of macrotroponin T, particularly without cTnI reactivity, have been rare. Although the clinical significance of macrotroponin is not fully understood, macroenzymes and complexes are recognised to cause confusion in interpretation of laboratory results. The potential for adverse clinical consequences due to misinterpretation of affected results is very high. Methods We describe four cases of macrotroponin T with persistently low high sensitivity cTnT (hs-cTnT) by the 9 min compared to the 18 min variant of the assay. Three cases were serendipitously identified due to the use of a lot number of Roche hs-cTnT affected by non-reproducible results, necessitating measurement of cTnT in duplicate. We identified and characterised these macrotroponin specimens by immunoglobulin depletion (Protein A and PEG precipitation), mixing studies with EDTA and recombinant cTnT. Results In cases of macro-cTnT, a lower result occurred on the hs-cTnT using the 9 min compared to 18 min variant assay (ratio of 9–18 min hs-cTnT <0.80). Mixing studies with recombinant cTnT or EDTA demonstrated a difference in recovery vs. controls. One of these patients demonstrated a high molecular weight complex for cTnI and cTnT demonstrating a macrocomplex involving both cTn. This patient demonstrated a rise and fall in cTn when measured by several commercial assays consistent with genuine acute cardiac injury. Conclusions We identified several cases of macro-cTnT and described associated clinical and biochemical features.

Factors associated with baseline and serial changes in circulating NT-proBNP and high-sensitivity cardiac troponin T in a population-based cohort (Dallas Heart Study)

2021 ◽  
Author(s):  
Christopher W Puleo ◽  
Colby R Ayers ◽  
Sonia Garg ◽  
Ian J Neeland ◽  
Alana A Lewis ◽  
...  
Keyword(s):  
Body Composition ◽  
Cardiac Troponin ◽  
Troponin T ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Cardiac Troponin T ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Heart Study ◽  
Dallas Heart Study

Aim: N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) associate with structural heart disease and heart failure risk in individuals without known cardiovascular disease (CVD). However, few data are available regarding whether factors influencing levels of these two biomarkers are similar or distinct. We performed serial measurement of NT-proBNP and hs-cTnT in a contemporary multiethnic cohort with extensive phenotyping, with the goal of identifying their respective biological determinants in a population without known or suspected CVD. Methods: We evaluated 1877 participants of the Dallas Heart Study who had NT-proBNP and hs-cTnT measured and were free from clinical CVD at the each of its two examinations (2000–2002 and 2007–2009). Variables collected included demographic and risk factors, high-sensitivity C-reactive protein, body composition via dual-energy x-ray absorptiometry, coronary artery calcium by computed tomography, and cardiac dimensions and function by cardiac MRI. Linear regression was used to identify associations of these factors with each biomarker at baseline and with changes in biomarkers over follow-up. Results: NT-proBNP and hs-cTnT were poorly correlated at baseline (Spearman rho 0.083, p = 0.015), with only moderate correlation between change values (rho 0.18, p < 0.001). hs-cTnT positively associated and NT-proBNP inversely associated with male gender and black race. At baseline, both NT-proBNP and hs-cTnT associated with left ventricular end-diastolic volume and wall thickness, but only NT-proBNP associated with left atrial size. Changes in cardiac dimensions between phases were more strongly associated with changes in NT-proBNP than hs-cTnT. NT-proBNP was more strongly associated with high-sensitivity C-reactive protein and measures of body composition than hs-cTnT. Conclusion: Among individuals without CVD in the general population, NT-proBNP and hs-cTnT are nonredundant biomarkers that are differentially associated with demographic and cardiac factors. These findings indicate that hs-cTnT and NT-proBNP may reflect different pathophysiological pathways.

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