Urine high-sensitive troponin I in children cannot offer an applicable alternative to serum

Area of Science:

• Pediatric Cardiology
• Biomarkers
• Cardiac Surgery

Background:

• Congenital heart defects are a leading cause of elevated cardiac troponin I in children.
• The clearance of cardiac troponin I and factors influencing it are not well understood.
• Cardiac troponin I is a known indicator of cardiac damage in adults.

Purpose of the Study:

• To investigate the role of cardiac troponin I in serum and urine as an indicator of cardiac damage in pediatric patients.
• To compare troponin I levels in children undergoing different cardiac surgical procedures.

Main Methods:

• Prospective study of 70 children under 24 months undergoing cardiac surgery (ventricular septal defect repair or partial cavopulmonary anastomosis).
• Serum and urine cardiac troponin I levels were measured at four time points post-surgery.
• A control group of healthy children had a single urine troponin I measurement.

Main Results:

• Serum cardiac troponin I increased postoperatively, returning to baseline levels.
• Significantly higher serum troponin I concentrations were observed in children who underwent ventricular septal defect repair.
• A positive correlation was found between serum troponin I levels and cardiopulmonary bypass/aortic cross-clamping times.
• Cardiac troponin I was generally undetectable in urine samples from all pediatric groups.

Conclusions:

• Serum cardiac troponin I is a useful biomarker for assessing cardiac damage in children post-cardiac surgery.
• Cardiac troponin I is not a reliable biomarker in pediatric urine due to its general undetectability.
• Factors such as urine pH, salt concentration, and low protein levels may contribute to the inability to detect troponin I in urine.