Circulating cardiac troponin I levels in Kawasaki disease
Circulating cardiac troponin I levels in Kawasaki disease
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DOI：
10.1007/s002460010170
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发表时间：
2001-03-01
影响因子：
1.6
通讯作者：
Shulman, ST
中科院分区：
文献类型：
--
作者：
Checchia, PA;Borensztajn, J;Shulman, ST
除了川崎病（KD）的血管表现外，在许多患者的川崎病急性期，心肌炎的临床、心电图和/或超声心动图征象也是可识别的。KD患者心肌炎的发病机制及其与后续冠状动脉异常的关系尚不清楚。先前对儿童人群血清心肌肌钙蛋白I （cTnI）测量的研究表明，测量在KD的诊断和随访中可能具有实用价值。我们设计了一项回顾性研究来评估急性KD期间的cTnI测量，并评估急性KD期间cTnI测量对随后冠状动脉异常发展的预测价值。对29名儿童进行了研究。第一组15例经胸超声心动图检查发现冠状动脉异常的KD患者。第二组为超声心动图显示冠状动脉持续正常的KD患者14例。对照组由11名儿童组成，其中没有一名已知有KD或心肌炎的临床表现。三组的平均cTnI值均低于提示心脏损伤的值：1组= 0.11 +/- 0.16 ng/ml， 2组= 0.15 +/- 0.34 ng/ml，对照组= 0.04 +/- 0.08 ng/ml。目前的研究表明，KD患者的cTnI水平没有显著升高。此外，cTnI测量与心肌炎的发现之间没有相关性，这可以通过心功能下降或随后冠状动脉异常的发展来反映。
In addition to the vascular findings of Kawasaki disease (KD), clinical, electrocardiographic, and/ or echocardiographic signs of myocarditis are recognizable in the acute phase of KD in many patients. The mechanism of myocarditis and an association with the development of subsequent coronary artery abnormalities in KD is unknown. Previous studies of serum cardiac troponin I (cTnI) measurements in pediatric populations have suggested a possible utility of measurements in diagnosis and follow-up of KD. We designed a retrospective study to evaluate cTnI measurements during acute KD and to assess the predictive value of cTnI measurements in acute KD for the subsequent development of coronary artery abnormalities. Twenty-nine children were studied. Group 1 consisted of 15 KD patients who developed coronary artery abnormalities as detected by transthoracic echocardiographic evaluation. Group 2 consisted of 14 KD patients with persistently normal coronary artery findings on echocardiograms. A control group consisted of 11 children, none of whom were known to have had clinical findings of KD or myocarditis. The mean cTnI values for all three groups were lower than the values suggestive of cardiac damage: group 1 = 0.11 +/- 0.16 ng/ml, group 2 = 0.15 +/- 0.34 ng/ml, and control = 0.04 +/- 0.08 ng/ml. The current study demonstrates that there is no significant elevation of cTnI in KD patients. Additionally, there is no correlation between cTnI measurements and the finding of myocarditis, as reflected by decreased cardiac function, or the subsequent development of coronary artery abnormalities.