Why the study?
Hypercatecholaminemia-related heart failure has been proposed as the primary cause of early mortality in enterovirus A71 infection, prompting measurement of urine catecholamine concentrations in severe cases.
Are urine catecholamine concentrations elevated in children with severe EV-A71 infection compared to pediatric septic shock?
Are urine catecholamine concentrations elevated in children with severe EV-A71 infection compared to pediatric septic shock?
Significantly elevated urine catecholamine concentrations in EV-A71-stage-4 patients support the hypothesis of hypercatecholaminemia-related heart failure and can serve as reliable biomarkers to differentiate severe EV-A71 infection with or without heart failure.
Answers are grounded in this paper and cite their sources.
May aid differentiation of EV-A71 heart failure from shock; leaves open prospective validation before clinical use.
Purpose: Hypercatecholaminemia-related heart failure has been proposed as the main cause of enterovirus A71-related (EV-A71) early mortality. The purpose of this study was to measure urine catecholamine concentrations in severe EV-A71-infected children. Methods: A total of 35 children, aged 2.5 ± 2.1 years, were divided into three groups. Group I: 15 septic shock patients, group II: 17 EV-A71-stage-2 patients, and group III: 3 EV-A71-stage-4 patients. The laboratory results, cardiac biomarkers and urine catecholamine concentrations were statistically analysed. Results: Group I had the highest C-reactive protein (CRP) levels and group II had the lowest B-type natriuretic peptide (BNP) and its N-terminal prohormone among the groups (p = 0.039, <0.01 and <0.01, respectively). Group III patients had significantly higher urine catecholamine and troponin-I values among the groups. If urine epinephrine (Epi) >134 ug/gCr, norepinephrine (NE) >176 ug/gCr and vanillylmandelic acid (VMA) >11.7 mg/gCr were used as the cutoff points to differentiate groups II and III, the sensitivities and specificity were all 100%. Conclusions: The significantly elevated urine catecholamine concentrations in EV-A71-stage-4 patients support the hypothesis that hypercatecholaminemia-related heart failure is involved in severe EV-A71 infection. Urine catecholamines could be used as reliable biomarkers for differentiation of severe EV-A71 infection with or without heart failure and septic shock.
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Jan et al. (2018) studied this question.
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