Circulating cardiac troponins levels and cardiac dysfunction in children with acute and fulminant viral myocarditis.
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.
Al-Biltagi
Mohammed
M
Department of Paediatric, Tanta University, Egypt. mbelrem@hotmail.com
Issa
Mona
M
Hagar
Hamdi Abo
HA
Abdel-Hafez
Maher
M
Aziz
Nahla Abdul
NA
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
D019210:Troponin I; D020107:Troponin T