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Troponin-T: improved diagnostic assessment of myocardial damage in childhood
F F Immer1, F Stocker, A M Seiler
1Division of Paediatric Cardiology, University Hospital, Berne, Switzerland.
Insights
Cardiac troponin-T (cTnT) effectively detects myocardial damage in children post-cardiac surgery. This sensitive marker shows higher specificity than other tests, improving pediatric cardiac care diagnostics.
Area of Science:
- Pediatric Cardiology
- Biomarkers
- Myocardial Injury
Background:
- Cardiac troponin-T (cTnT) is a validated marker for myocardial damage in adults.
- Its utility and diagnostic performance in pediatric populations, particularly after cardiac surgery, remain less established.
Purpose of the Study:
- To evaluate the diagnostic accuracy and clinical utility of cTnT in pediatric patients with suspected or confirmed myocardial damage.
- To compare the sensitivity and specificity of cTnT against other cardiac biomarkers (CK, CK-MB) in this cohort.
Main Methods:
- Prospective measurement of cTnT, CK, CK-MB activity, and CK-MB-Mass in 85 children (1 day-204 months) undergoing cardiac surgery or with suspected myocardial damage.
- Serial blood sampling preoperatively and up to 4 times in the first 55 hours postoperatively.
Main Results:
- Elevated cTnT levels were observed postoperatively in children with intracardiac surgery, indicating myocardial damage.
- Children undergoing extracardiac surgery of great vessels did not show a significant cTnT increase.
- cTnT demonstrated superior specificity and sensitivity compared to CK and CK-MB for assessing myocardial damage in pediatric cardiac surgery patients.
Conclusions:
- Cardiac troponin-T is a highly sensitive and specific biomarker for detecting myocardial damage in children following cardiac surgery.
- The use of cTnT can significantly enhance the diagnostic assessment of myocardial injury in pediatric cardiology.
- Further research may establish standardized pediatric reference ranges and clinical guidelines for cTnT utilization.
Abstract:
Troponin-T (cTnT) as a marker of myocardial damage is well established in adults, but not yet in children. cTnT was measured in 85 children (aged 1 day-204 months, mean 46 months). Twenty-five children were non-surgical patients, with possible myocardial damage suspected on clinical grounds. The other 60 patients had cardiac surgery leading to a defined myocardial damage. In these children, troponin-T (cTnT), creatine kinase activity (CK), creatine kinase-MB activity (CK-MB), and creatine kinase-MB-Mass (CK-MB-Mass) were measured preoperatively and 3-4 times during the first 55 postoperative h. Except in four children with probable preoperative myocardial damage, all troponin-T values were in the normal range (< 0.1 microg/l). All children with intracardiac surgery showed a postoperative increase in troponin-T. Children with extracardiac surgery of the great vessels showed no postoperative increase of troponin-T. For the assessment of myocardial damage, troponin-T was more specific and more sensitive than the other markers tested, troponin-T might significantly improve the diagnostic assessment of myocardial damage in children.