Assessment of myocardial involvement using cardiac troponin-I and echocardiography in rheumatic carditis in Izmir, Turkey.
BACKGROUND
Acute rheumatic carditis is still a major problem in developing countries. Cardiac troponin-I (cTnI) has been identified as a sensitive and specific marker in the diagnosis of myocarditis in children and adults.


METHODS
A prospective study was performed using Doppler echocardiography and cTnI in order to detect myocardial involvement in 26 consecutive patients with acute rheumatic valvular disease. Patients were divided into two groups: group 1, rheumatic fever with carditis (n > 16); group 2, rheumatic fever without carditis (n > 10).


RESULTS
Clinically age, gender, body temperature, heart rate and white blood count did not differ significantly between the groups and the age-matched control group. C-reactive protein, erythrocyte sedimentation rate, anti-streptolysin-O were significantly different. Left ventricular fractional shortening was normal in all patients (group 1, 37 +/- 10%; group 2, 34 +/- 5%; NS). Left ventricular dimensions were larger in group 1, in which all patients except two had moderate to severe mitral and/or aortic valvular regurgitation (5.05 +/- 0.75 cm/m(2)) compared to group 2, in which none had valvular regurgitation (3.27 +/- 0.26 cm/m(2), P < 0.05). None of the patients in either group presented with or developed pericarditis. Mean cTnI was 0.12 +/- 0.034 ng/mL in group 2 and 0.077 +/- 0.02 in group 1, the difference of which was not statistically significant. Neither significant cTnI elevations nor echocardiographic systolic function abnormalities were found in the present patients with rheumatic carditis.


CONCLUSIONS
The present results indicate the absence of myocardial involvement in acute rheumatic carditis without congestive heart failure.
Tavli
Vedide
V
Division of Pediatric Cardiology, Izmir Dr Behçet Uz Children's Hospital, Izmir, Turkey. vedidetavli@hotmail.com
Canbal
Abdullah
A
Saylan
Berna
B
Saritaş
Türkay
T
Meşe
Timur
T
Atlihan
Füsun
F
D000208:Acute Disease; D015415:Biomarkers / Q000097:blood*; D002648:Child; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000175:diagnosis*; D011446:Prospective Studies; D012214:Rheumatic Heart Disease / Q000175:diagnosis*; D019210:Troponin I / Q000097:blood*; D014421:Turkey
D015415:Biomarkers; D019210:Troponin I