Cardiac troponin I, cardiac troponin-specific autoantibodies and natriuretic peptides in children with hypoplastic left heart syndrome.
Cardiac troponin I, cardiac troponin-specific autoantibodies and natriuretic peptides in children with hypoplastic left heart syndrome.
复制标题
左心发育不全综合征儿童的心肌肌钙蛋白 I、心肌肌钙蛋白特异性自身抗体和利尿钠肽。
DOI：
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发表时间：
2014
影响因子：
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通讯作者：
J. Pihkala
中科院分区：
文献类型：
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作者：
Anneli Eerola;T. Poutanen;Tanja Savukoski;K. Pettersson;H. Sairanen;E. Jokinen;J. Pihkala
目标
评估左心发育不全综合征 (HLHS) 儿童治疗期间心肌肌钙蛋白 I (cTnI)、心肌肌钙蛋白自身抗体 (cTnAAbs) 和利尿钠肽的血清水平。
方法
在一项前瞻性研究中，我们对 18 名连续 HLHS 儿童进行了诺伍德手术前、双向格伦 (BDG) 手术前、一岁时和全腔静脉肺连接 (TCPC) 前的血清样本分析。此外，我们对 TCPC 前接受检查的 22 名儿童进行了一项横断面研究。对照组包括 34 名健康儿童。
结果
在前瞻性研究中，诺伍德手术前八名儿童的肌钙蛋白 I 呈阳性。在下一次随访中，六名儿童呈阳性。此后，在所有样本中，cTnI 均为阴性。治疗期间利尿钠肽的血清水平有所下降，但在整个研究过程中仍高于对照组。在横断面研究中，cTnI 水平呈阴性，但利钠肽水平高于对照组。 cTnI 和利尿钠肽的水平与氧饱和度或血红蛋白浓度没有相关性。一名患者出现了针对心肌肌钙蛋白的自身抗体，但对照儿童中没有出现。
结论
Norwood 和 BDG 手术前心脏 TnI 释放很常见；然后，在 HLHS 治疗方案期间，cTnI 释放得到缓解，血清钠尿肽水平降低。这可能反映了手术过程中右心室容量超负荷的减少。
OBJECTIVES
To evaluate serum levels of cardiac troponin I (cTnI), autoantibodies against cardiac troponin (cTnAAbs) and natriuretic peptides during the treatment protocol in children with hypoplastic left heart syndrome (HLHS).
METHODS
In a prospective study, we had 18 consecutive children with HLHS, for whom serum samples were analysed before the Norwood operation, before the bidirectional Glenn (BDG) operation, at the age of one year and before total cavo-pulmonary connection (TCPC). In addition, we performed a cross-sectional study in 22 children examined before TCPC. Controls comprised 34 healthy children.
RESULTS
In the prospective study, troponin I was positive in eight children before the Norwood operation. At the next follow-up, six children were positive. Thereafter, in all samples, cTnI was negative. Serum levels of natriuretic peptides decreased during the treatment protocol but remained higher than in controls throughout the study. In the cross-sectional study, cTnI levels were negative, but levels of natriuretic peptides were higher than in controls. Levels of cTnI and natriuretic peptides showed no correlation with oxygen saturation or haemoglobin concentration. Autoantibodies against cardiac troponin appeared in one patient but not in the control children.
CONCLUSIONS
Cardiac TnI release is common before Norwood and BDG operations; then during the treatment protocol for HLHS, cTnI release resolves and serum levels of natriuretic peptides decrease. This may reflect a reduction of volume overload of the right ventricle during the surgical programme.