title: Circulating cardiac troponins levels and cardiac dysfunction in children with acute and fulminant viral myocarditis.
abstract: OBJECTIVE
  To study the correlation between cardiac troponins blood levels and degrees of cardiac dysfunction in children with acute and fulminant viral myocarditis and to study their prognostic role in predicting the outcomes and risk of having dilated cardiomyopathy.
  
  
  METHODS
  Troponin I & T blood levels were measured in 65 children with acute or fulminant viral myocarditis. The cardiac functions of RV & LV were assessed by Doppler echocardiography.
  
  
  RESULTS
  The levels of cTnI & CTnT were significantly higher in patients with fulminant myocarditis than in controls and children with acute myocarditis (p < 0.05 & <0.001* respectively). The cardiac functions were significantly impaired in fulminant myocarditis than in acute myocarditis (p < 0.001*). There were negative correlations between the cardiac troponins levels and the cardiac functions measured by echocardiography in children with acute and fulminant myocarditis. There were 3 deaths (7.5%), and 10 (25%) children developed dilated cardiomyopathy in acute myocarditis while there were eight deaths (32%) and one patient (4%) who developed dilated cardiomyopathy in fulminant myocarditis group.
  
  
  CONCLUSIONS
  Cardiac troponins levels can predict the severity of myocarditis and the prognosis on the short-term level. Fulminant myocarditis was associated with higher levels of both cTn I & cTn T than acute myocarditis. Despite that fulminant myocarditis has a more aggressive course, the risk of developing cardiomyopathy was less than in acute myocarditis.
authors.affiliation: Department of Paediatric, Tanta University, Egypt. mbelrem@hotmail.com
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Biltagi
authors.forename: Mona
authors.initials: M
authors.lastname: Issa
authors.forename: Hamdi Abo
authors.initials: HA
authors.lastname: Hagar
authors.forename: Maher
authors.initials: M
authors.lastname: Abdel-Hafez
authors.forename: Nahla Abdul
authors.initials: NA
authors.lastname: Aziz
mesh_terms: D000208:Acute Disease; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009205:Myocarditis / Q000097:blood* / Q000401:mortality / Q000503:physiopathology / Q000821:virology; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*; D018608:Ultrasonography, Doppler
chemical_list: D019210:Troponin I; D020107:Troponin T