Recent research published in the International Journal of Pediatric Research has found out that Higher levels of highly sensitive cardiac troponin T (hs-cTnT) suggest myocardial injury in children with acyanotic congenital heart disease (ACHD) and may be useful to stratify children for early surgical intervention before irreversible damage occurs.
In acyanotic congenital heart disease, anatomical defects are associated with abnormalities in hemodynamic load and neurohormonal activation. This results in myocardial damage which may not be entirely reversible.
Biomarkers are important tools which can be used for assessment of the disease and injury to the myocardium. Cardiac troponins are one such biomarker that regulates the interaction between actin and myosin in cardiac myocytes.
Therefore, Rishika Das and colleagues from the Department of Pediatrics, Maulana Azad Medical College, Associated Lok Nayak Hospital, New Delhi, India conducted the present study to evaluate the occurrence of myocardial injury in acyanotic congenital heart disease (ACHD) using highly sensitive cardiac troponin T (hs-cTnT) as a biomarker.
The authors carried out an observational cross sectional study at a tertiary care center. Stable children with ACHD aged between 6 months to 5 years were selected as cases and age matched children without ACHD as controls.
Echocardiography was done in all the patients with clinical findings of ACHD. A total of 83 children (55 cases and 28 controls) were enrolled. The severity of the ACHD was determined by the defect size and the pressure gradient across the defect on echocardiography.
Levels of hs-cTnT were measured using electrochemiluminesence assay. These levels were co-related with the defect size and the pressure gradient.
The key findings seen were-
a. The mean levels of hs-cTnT were significantly higher among the cases (0.044 ng/ml) than the controls (0.005 ng/ml), (p < 0.001).
b. A positive correlation was noted between the defect size and the levels of hs-cTnT (r = 0.276 and the p value = 0.042) and an inverse relationship of the levels of hs-cTnT was seen with pressure gradient (r = -0.444 and the p value = 0.001).
c. The development of pulmonary HTN was associated with higher levels of hs-cTnT.
Therefore, higher levels of hs-cTnT suggest myocardial injury in children with ACHD and may be useful to stratify children for early surgical intervention before irreversible damage occurs, the authors concluded.