scholarly journals Serum High Sensitive Cardiac Troponin-T (hs-cTnT) as a Biomarker in Pediatric Pulmonary Hypertension due to Congenital Left to Right Cardiac Shunt

2020 ◽  
pp. 156-163
Author(s):  
Hadeer Thabet Abd El Sameaa ◽  
Ahmed Hamdy Shabana ◽  
Desoky Ezzat Abo Ammo ◽  
Amr Mohamed Zoair
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Cardiac Troponin ◽  
Congenital Heart ◽  
Myocardial Injury ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Pulmonary Pressure ◽  
Cardiac Shunt

Background: Pulmonary arterial hypertension (PAH) is a frequent complication of congenital heart disease (CHD) with left-to-right shunt. Increased pulmonary pressure leads to vascular remodeling and RV dysfunction. Objectives: To analyze the role of  high-sensitive cardiac  troponin T (hs -cTnT) in the determination of myocardial injury caused by volume and pressure load due to pulmonary hypertension (PH) in children with left to right cardiac shunt. Patients and Methods: Twenty  patients with congenital heart disease (CHD) with left to right shunt and PAH-CHD, 20 patients with CHD with left to right shunt but without PH, and 20 healthy children, in total 60 individuals, were included in the study. All cases aged between 3 and 36 months. Plain x-ray chest and heart, electrocardiography, Doppler and Two –dimensional, M- mode echocardiographic evaluation of CHD and pulmonary pressure were performed in all patients. Blood samples were obtained from all cases for measurement of serum high-sensitive cardiac troponin T (hs-cTnT) levels by highly sensitive third-generation quantitative test. Results: The mean hs-cTnT levels were significantly higher in patients with PH than in patients without PH (p < 0.05) with a sensitivity 70% and specificity 95%. A statistically significant positive correlation was determined between pulmonary artery pressure and hs-cTnT levels, and significant negative correlation with EF% and FS %( by echocardiography). Conclusions: Serum levels of high-sensitive cardiac troponin T (hs-cTnT) were significantly elevated in PAH-CHD children denoting myocardial injury caused by volume and pressure load due to PH in children with left to right cardiac shunts, so it could be used as a cardiac biomarker in PAH-CHD children with good diagnostic and prognostic value and high sensitivity and specificity, which may be useful in the management of PH in childhood.

scholarly journals The prognostic value of high sensitivity cardiac troponin T in patients with congenital heart disease

2018 ◽  
Vol 71 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Masayuki Abiko ◽  
Kei Inai ◽  
Eriko Shimada ◽  
Seiji Asagai ◽  
Toshio Nakanishi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Congenital Heart ◽  
Troponin T ◽  
High Sensitivity ◽  
Cardiac Troponin T

scholarly journals Cardiac troponin I, cardiac troponin T, and creatine kinase MB in dialysis patients without ischemic heart disease: evidence of cardiac troponin T expression in skeletal muscle

1997 ◽  
Vol 43 (6) ◽  
pp. 976-982 ◽  
Author(s):  
Mary D McLaurin ◽  
Fred S Apple ◽  
Ellen M Voss ◽  
Charles A Herzog ◽  
Scott W Sharkey
Keyword(s):  
Skeletal Muscle ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiac Troponin ◽  
First Generation ◽  
Troponin T ◽  
Ischemic Heart ◽  
Cardiac Troponin T ◽  
Dialysis Patients ◽  
Acute Ischemic Heart Disease

Abstract Serum cardiac troponin T (cTnT) concentrations are frequently increased in chronic dialysis patients as measured by the first-generation ELISA immunoassay, as is creatine kinase (CK) MB mass in the absence of acute ischemic heart disease. We designed this study to compare four serum markers of myocardial injury [CK-MB mass, first-generation ELISA cTnT, second-generation Enzymun cTnT, and cardiac troponin I (cTnI)] in dialysis patients without acute ischemic heart disease. We also evaluated skeletal muscle from dialysis patients as a potential source of serum cTnT. No patients in the clinical evaluation group (n = 24) studied by history and by physical examination, electrocardiography, and two-dimensional echocardiography had evidence of ischemic heart disease. Biochemical markers were measured in serial predialysis blood samples with specific monoclonal antibody-based immunoassays. For several patients at least one sample measured above the upper reference limit: CK-MB, 7 of 24 (30%); ELISA cTnT, 17 of 24 (71%); Enzymun cTnT, 3 of 18 (17%); and cTnI, 1 of 24 (4%). In a separate group of dialysis patients (n = 5), expression of cTnT, but not cTnI, was demonstrated by Western blot analysis in 4 of 5 skeletal muscle biopsies. Chronic dialysis patients without acute ischemic heart disease frequently had increased serum CK-MB and cTnT. The specificity of the second-generation cTnT (Enzymun) assay was improved over that of the first-generation (ELISA) assay; cTnI was the most specific of the currently available biochemical markers. cTnT, but not cTnI, was expressed in the skeletal muscle of dialysis patients.

scholarly journals Prevalence and profile of congenital heart disease and pulmonary hypertension in Down syndrome in a pediatric cardiology service

2014 ◽  
Vol 32 (2) ◽  
pp. 159-163 ◽  
Author(s):  
Felipe Alves Mourato ◽  
Lúcia Roberta R. Villachan ◽  
Sandra da Silva Mattos
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Heart Diseases ◽  
Heart Defects ◽  
Descriptive Analysis ◽  
Atrioventricular Septal Defect

OBJECTIVE:To determine the frequence and profile of congenital heart defects in Down syndrome patients referred to a pediatric cardiologic center, considering the age of referral, gender, type of heart disease diagnosed by transthoracic echocardiography and its association with pulmonary hypertension at the initial diagnosis.METHODS:Cross-sectional study with retrospective data collection of 138 patients with Down syndrome from a total of 17,873 records. Descriptive analysis of the data was performed, using Epi-Info version 7.RESULTS: Among the 138 patients with Down syndrome, females prevailed (56.1%) and 112 (81.2%) were diagnosed with congenital heart disease. The most common lesion was ostium secundum atrial septal defect, present in 51.8%, followed by atrioventricular septal defect, in 46.4%. Ventricular septal defects were present in 27.7%, while tetralogy of Fallot represented 6.3% of the cases. Other cardiac malformations corresponded to 12.5%. Pulmonary hypertension was associated with 37.5% of the heart diseases. Only 35.5% of the patients were referred before six months of age.CONCLUSIONS: The low percentage of referral until six months of age highlights the need for a better tracking of patients with Down syndrome in the context of congenital heart disease, due to the high frequency and progression of pulmonary hypertension.

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