Cardiac troponin I in pediatrics: Normal values and potential use in the assessment of cardiac injury☆,☆☆
Section snippets
Patient population
Initial studies surveyed cTnI concentrations in two broad population groups (designated A and B) in relation to a variety of general pediatric diseases between January 1994 and December 1995.
Group A patients included ambulatory pediatric patients, further subdivided into two groups: group A1 , 120 ambulatory pediatric patients (73 boys/47 girls, mean age 11.6 months, range 0 to 29 months) without apparent heart disease, but with a variety of other pediatric diseases (clinic patients); and group
RESULTS
Serum cTnI values were less than 2.0 ng/ml in 117 of the 120 ambulatory patients without cardiac disease (group A1) and were frequently below the level of detection for the assay, regardless of diagnosis (Table I A).
Diagnosis cTnI ≤2 Gastrointestinal disorders Diarrhea 14 Vomiting 11 Failure to thrive 6 Constipation 6 Hepatitis 4 Short gut syndrome 3 Gastroesophageal reflux 4 Neurologic disorders Seizures* 21 Cerebral palsy 5 Developmental delay 3
DISCUSSION
We have shown that cTnI values are usually less than 2.0 ng/ml in the absence of discernible myocardial damage in a wide variety of different pediatric conditions. This finding was consistent in infants and children with hemodynamically stable cyanotic and acyanotic congenital, and nonacute acquired heart disease. It is also evident from our results that moderate elevation of cTnI (<8.0 ng/ml) is rare in a pediatric population, except in critically ill patients. All three critically ill
Acknowledgements
We thank Marsha Kuhns for technical assistance.
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Reprint requests: Michael Landt, PhD, Department of Pediatrics, Washington University School of Medicine, One Children's Place, St. Louis, MO 63110.