Why the study?
Does serum cardiac Troponin T (cTnT) measurement identify myocardial necrosis in pediatric patients with acute rheumatic fever and carditis?
Does serum cardiac Troponin T (cTnT) measurement identify myocardial necrosis in pediatric patients with acute rheumatic fever and carditis?
Normal cardiac Troponin T levels in acute rheumatic fever carditis suggest that heart failure in this setting is driven by severe valvular regurgitation rather than myocardial necrosis.
Answers are grounded in this paper and cite their sources.
Normal cTnT in pediatric ARF carditis supports valvular regurgitation over necrosis as HF driver; leaves open diagnostic utility pending larger studies.
OBJECTIVE: Acute rheumatic fever (ARF) is an endemic disease observed in children of developing countries. The purpose of this study was to test if it was possible to identify myocardial involvement in cases with rheumatic carditis by the measurement of serum cardiac TnT. METHODS: 30 patients diagnosed as ARF underwent echocardiography and their cardiac troponin T (cTnT) serum levels were measured. Patients were divided into group 1: Arthritis alone, group 2: carditis, and group 3 carditis with congestive heart failure (CHF). RESULTS: cTnT serum levels were normal in all except one patient with in group 3. Two patients in carditis (group 2) and three patients in CHF (group 3) had dilation in left ventricular end diastolic diameter. CONCLUSIONS: Normal cTnT levels in our patient group suggests that inflammation rather than myocardial necrosis is predominant in ARF carditis.
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Kardelen et al. (2011) studied this question.
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