Volume Overload and Pressure Overload due to Left-to-Right Shunt-Induced Myocardial Injury - Evaluation Using a Highly Sensitive Cardiac Troponin-I Assay in Children With Congenital Heart Disease -
Volume Overload and Pressure Overload due to Left-to-Right Shunt-Induced Myocardial Injury - Evaluation Using a Highly Sensitive Cardiac Troponin-I Assay in Children With Congenital Heart Disease -
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DOI：
10.1253/circj.cj-10-1211
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发表时间：
2011-09-01
影响因子：
3.3
通讯作者：
Kajino, Hiroki
中科院分区：
文献类型：
--
作者：
Sugimoto, Masaya;Ota, Kei;Kajino, Hiroki
背景：心肌肌钙蛋白I （Cardiac troponin I, cTnI）目前被认为是急性冠脉综合征和急性心肌梗死最敏感、最特异的生化标志物。然而，很少有报道描述使用cTnI检测来评估先天性心脏病（CHD）患儿的异常血流动力学负荷。据推测，由左向右分流引起的显著血流动力学负荷引起心肌损伤。方法与结果：采用高灵敏度cTnI测定法测定30例房间隔缺损（ASD）患儿、32例室间隔缺损（VSD）患儿和350例健康患儿血清cTnI水平。对ASD和VSD患儿行心导管插管，测定肺血流与全身血流之比、肺动脉压与全身动脉压之比（Pp/Ps）、肺血管阻力指数、左、右心室舒张末期容积。ASD和VSD患儿血清cTnI水平均显著高于健康儿童（P . 539）
Background: Cardiac troponin I (cTnI) is currently considered to be the most sensitive and specific biochemical marker of acute coronary syndrome and acute myocardial infarction. However, few reports have described the use of cTnI assays for evaluating abnormal hemodynamic load in children with congenital heart disease (CHD). It was hypothesized that significant hemodynamic overload due to a left-to-right shunt induces myocardial injury.Methods and Results: A highly sensitive cTnI assay was used to measure the serum cTnI levels in 30 children with atrial septal defect (ASD), 32 children with ventricular septal defect (VSD), and 350 healthy children. Cardiac catheterization was performed in the children with ASD and VSD to determine the ratio of pulmonary to systemic blood flow, the ratio of pulmonary to systemic arterial pressure (Pp/Ps), the pulmonary vascular resistance index, and the right and left ventricular end-diastolic volume. Serum cTnI levels in both the ASD and VSD children were significantly higher than those in healthy children (P