Frequency of clinically unsuspected myocardial injury at a children's hospital.
Frequency of clinically unsuspected myocardial injury at a children's hospital.
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儿童医院发生临床未怀疑的心肌损伤的频率。
DOI：
10.1016/j.ahj.2005.06.029
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发表时间：
2006
影响因子：
4.8
通讯作者：
Rifai,Nader
中科院分区：
文献类型：
--
作者：
Lipshultz,StevenE;Wong,JuliaCL;Lipsitz,StuartR;Simbre2nd,ValerianoC;Zareba,KarolinaM;Galpechian,Vartouhi;Rifai,Nader
儿童有心肌损伤的风险，但很少筛查心肌损伤。患病儿童中这种损伤的频率尚不清楚。血浆心肌肌钙蛋白I（cTnI）水平升高可以检测亚临床心肌损伤。METHODS我们测量cTnI水平从283儿童医院，波士顿患者（中位年龄2.10岁，范围0.13-22.4岁）在门诊或急诊诊所没有临床明显的心脏病。我们将≥0.5 ng/mL作为心肌损伤的指标。我们还测量了血浆肌酸激酶MB、总肌酸激酶和肌红蛋白，并进行了病历回顾。193名急性病儿童中有15名（7.8%）和90名健康儿童中有4名（4.4%）cTnI水平升高（P = 0.44）。在急性病组中，cTnI升高的儿童年龄较小，平均血红蛋白和红细胞压积水平较低。心肌肌钙蛋白I水平与肌酸激酶MB相关（r = 0.22; P <0.001），但与肌酸激酶或肌红蛋白无关。4名cTnI >0.89 ng/mL的儿童也测量了血浆心肌肌钙蛋白T，显示心肌肌钙蛋白T升高，与成人不稳定型心绞痛水平一致。4名儿童有高水平的cTnI升高（>2 ng/mL）与成人急性心肌梗死水平一致。结论cTnI水平升高发生在没有临床明显心脏疾病的儿童中，可以达到成人不稳定型心绞痛或急性心肌梗死水平。前瞻性研究，以确定这些结果的临床意义和它们的关系，心肌病的发展是必要的。
BACKGROUNDIll children are at risk but rarely screened for myocardial injury. The frequency of such injury in ill children is unknown. Elevated levels of plasma cardiac troponin I (cTnI) can detect subclinical myocardial injury.METHODSWe measured cTnI levels from 283 Children's Hospital, Boston patients (median age 2.10 years, range 0.13-22.4 years) seen in an outpatient or emergency clinic without clinically apparent cardiac disease. We took ≥0.5 ng/mL as an indication of myocardial injury. We also measured plasma creatine kinase–MB, total creatine kinase, and myoglobin, and performed a chart review.RESULTSFifteen (7.8%) of the 193 acutely ill children and 4 (4.4%) of the 90 well children had an elevated cTnI level (P = .44). Within the acutely ill group, the children with elevated cTnI were younger and had lower mean hemoglobin and hematocrit levels. Cardiac troponin I levels correlated with creatine kinase–MB (r = 0.22; P < .001) but not with creatine kinase or myoglobin. The 4 children with cTnI >0.89 ng/mL, who also had plasma cardiac troponin T measured, showed cardiac troponin T elevations that were consistent with unstable angina levels in adults. Four children had high-level cTnI elevations (>2 ng/mL) consistent with acute myocardial infarction levels in adults.CONCLUSIONSElevated cTnI levels occur in children without clinically apparent cardiac disease and can be at adult unstable angina or acute myocardial infarction levels. Prospective studies to determine the clinical significance of these findings and their relationship to the development of cardiomyopathy are warranted.
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影响因子：
4.8
作者：
MORGERA, T;DILENARDA, A;CAMERINI, F
通讯作者：
CAMERINI, F
寻找特异性：肌钙蛋白*
DOI：
10.1016/1062-1458(95)94006-l
发表时间：
1995
期刊：
Acc Current Journal Review
影响因子：
--
作者：
A. Jaffe
通讯作者：
A. Jaffe
心肌肌钙蛋白 T：其在临床疑似儿童急性心肌炎和慢性扩张型心肌病诊断中的作用
影响因子：
1.6
作者：
J. Soongswang;K. Durongpisitkul;S. Ratanarapee;W. Leowattana;A. Nana;D. Laohaprasitiporn;S. Akaniroj;N. Limpimwong;C. Kangkagate
通讯作者：
C. Kangkagate
影响因子：
--
作者：
L. P. Scott;M. F. Gutelius;R. Parrott
通讯作者：
R. Parrott
常见病毒性疾病对心脏的影响。
影响因子：
9.6
作者：
Terrence J. Montague;T. Marrie;David J. Bewick;C. A. Spencer;Fred Kornreich;B. Horáček
通讯作者：
B. Horáček