Document Detail

Cardiac troponin T: its role in the diagnosis of clinically suspected acute myocarditis and chronic dilated cardiomyopathy in children.
MedLine Citation:
PMID:  12211203     Owner:  NLM     Status:  MEDLINE    
This study was conducted to assess the use of the serum cardiac troponin T (cTnT) level as a noninvasive indicator to differentiate acute myocarditis and chronic dilated cardiomyopathy in pediatric patients. Myocarditis and dilated cardiomyopathy are clinically difficult to differentiate. Endomyocardial biopsy proved to be quite useful. However, the nature of the procedure--invasiveness, time-consuming, and limited sensitivity--caused some concerns, especially in pediatric patients. Hence, we attempted to find an alternative method that could give a prompt diagnosis of acute myocarditis. Twenty cases with clinically suspected myocarditis or dilated cardiomyopathy and a control group of 21 cases with moderate left-to-right shunt and congestive heart failure were recruited. History, physical examination, electrocardiogram, chest roentgenogram, echocardiogram, cTnT, creatine kinase MB isoenzyme (CK-MB mass), and/or endomyocardial biopsy were compared. The gold standard used to diagnose myocarditis is endomyocardial biopsy (Dallas criteria) and/or recovery from cardiovascular problems within 6 months of follow-up. Ten patients were diagnosed as having myocarditis (group 1) and 10 with chronic dilated cardiomyopathy (group 2). The control group of 21 cases was designated as group 3. The median serum cTnT levels were 0.088 (0.04-3.11), 0.010 (0.010-0.990), and 0.010 (0.010-0.550) ng/ml in groups 1, 2, and 3, respectively. The mean CK-MB mass level for groups, 1, 2, and 3 were 18.35 (7.14-70.00), 4.80 (0.54-108.00), and 2.26 (0.95-7.06) ng/ml. The study showed that both the cTnT and CK-MB mass levels were significantly higher in group 1 than either group 2 or group 3. Histopathology was studied in 9 cases. In 2 of 5 cases and in all 4 cases in group 1 and group 2 histopathology was pathologically proved. Levels of cTnT and CK-MB were significantly higher for myocarditis than for dilated cardiomyopathy and left-to-right shunt with CHF. Further study is needed to assess the optimum cTnT level for differentiating both conditions.
J Soongswang; K Durongpisitkul; S Ratanarapee; W Leowattana; A Nana; D Laohaprasitiporn; S Akaniroj; N Limpimwong; C Kangkagate
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric cardiology     Volume:  23     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:    2002 Sep-Oct
Date Detail:
Created Date:  2002-09-03     Completed Date:  2002-09-27     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  531-5     Citation Subset:  IM    
Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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MeSH Terms
Acute Disease
Analysis of Variance
Biological Markers
Cardiomyopathy, Dilated / blood,  diagnosis*
Case-Control Studies
Child, Preschool
Chronic Disease
Creatine Kinase / blood
Creatine Kinase, MB Form
Diagnosis, Differential
Isoenzymes / blood
Myocarditis / blood,  diagnosis*
Prospective Studies
Troponin / blood*
Troponin T
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Troponin; 0/Troponin T; EC Kinase; EC Kinase, MB Form

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