Myocardial involvement in the hemodynamic abnormalities associated with acute rheumatic fever.
OBJECTIVE
Rheumatic fever is still a common cause of acquired heart disease in children and young adult in many developing countries. The aim was to investigate the role of myocardial involvement in the hemodynamic changes in patients with acute rheumatic fever using cardiac troponin assay and echocardiography.


METHODS
A prospective cohort study was designed.


METHODS
Thirty-four children with acute rheumatic fever, 20 with carditis, and 14 without carditis. Level of cardiac troponin T (cTnT) and echocardiographic measurement of left ventricular function were the main outcome measure.


RESULTS
The level of cardiac troponin in children with carditis was 0.051 ± 0.01 ng/dL, and it was 0.039 ± 0.02 ng/dL in those without carditis. The difference is not significant. In addition, there was no significant difference between the children with carditis and those without carditis regarding left ventricular ejection and shortening fractions.


CONCLUSIONS
There are no significant echocardiographic measurements abnormalities or cTnT levels elevation suggesting clinically relevant hemodynamic abnormalities due to myocardial involvement during acute rheumatic fever.
Department of Cardiology, Suez Canal University, Ismailia, Egypt.
Gamela
G
Nasr
Badr
B
Mesbah
Alaa
A
Saad
Am J Cardiol. 2002 Mar 15;89(6):779-82
11897228
BMJ. 2004 May 1;328(7447):1028-9
15117768
Pediatr Int. 2000 Feb;42(1):71-5
10703240
Heart. 2004 Jun;90(6):689-90
15145883
J Infect Dis. 2001 Feb 1;183(3):507-11
11133385
Am J Cardiol. 2002 Dec 1;90(11):1277-8
12450620
Med Sci Sports Exerc. 2002 Apr;34(4):651-4
11932574
J Assoc Physicians India. 2007 Apr;55:276-80
17694787
World Health Organ Tech Rep Ser. 2004;923:1-122, back cover
15382606
J Rheumatol. 2001 Jul;28(7):1681-8
11469479
Indian J Pediatr. 2001 Oct;68(10):943-4
11758130
Int J Cardiol. 2003 Feb;87(2-3):223-30
12559543
Cardiol Young. 2001 May;11(3):255-60
11388618
Cardiol Young. 2002 Dec;12(6):519-23
12635999
J Am Coll Cardiol. 2001 Jan;37(1):201-7
11153739
JAMA. 1992 Oct 21;268(15):2069-73
1404745
Pediatr Int. 2008 Feb;50(1):62-4
18279207
Chest. 2008 Jun;133(6 Suppl):593S-629S
18574274