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High-sensitivity cardiac troponin T in infants exposed to anti-Ro antibodies

Julie Barsalou1, Edgar Jaeggi2, Lars Grosse-Wortmann2,3

  • 1Division of Pediatric Rheumatology, The Hospital for Sick Children, University of Toronto, Toronto, Canada.

Rheumatology (Oxford, England)
|March 13, 2023
PubMed

Insights

High-sensitivity cardiac troponin T (hs-cTnT) levels are not routinely indicated for infants exposed to anti-Ro antibodies, as they often fall within normal ranges and do not reliably predict cardiac involvement in neonatal lupus erythematosus (NLE). Further research is needed to clarify its role as a biomarker.

Area of Science:

  • Pediatrics
  • Cardiology
  • Immunology

Background:

  • Neonatal lupus erythematosus (NLE) can manifest as cardiac involvement, including myocarditis and endocardial fibroelastosis (EFE).
  • The utility of high-sensitivity cardiac troponin T (hs-cTnT) in detecting subclinical myocardial inflammation in infants exposed prenatally to anti-Ro antibodies remains unclear.

Purpose of the Study:

  • To investigate hs-cTnT levels in infants exposed to anti-Ro antibodies, with or without cardiac NLE.
  • To correlate hs-cTnT levels with cardiac magnetic resonance imaging (CMR) findings in a subset of these infants.

Main Methods:

  • A cohort of 45 infants exposed prenatally to anti-Ro antibodies were assessed.
  • hs-cTnT levels were measured, and CMR was performed in select infants with elevated levels (≥30 ng/l).

Main Results:

  • Only 3 out of 45 infants had hs-cTnT levels outside the reference range for healthy infants.
  • No subclinical myocarditis or EFE was detected by CMR in any of the 12 infants who underwent the procedure.
  • Elevated hs-cTnT levels were observed in infants with and without cardiac NLE, with some levels guiding treatment adjustments.

Conclusions:

  • Routine hs-cTnT measurement is not recommended for all infants exposed to anti-Ro antibodies.
  • The role of hs-cTnT as a biomarker for cardiac NLE requires further investigation.
Abstract

Keywords:
cardiac neonatal lupushigh-sensitivity cardiac troponin T

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