Cardiac troponin I in pediatrics: Normal values and potential use in the assessment of cardiac injury

R. Hirsch, Y. Landt, S. Porter, C. E. Canter, Allan S Jaffe, J. H. Ladenson, J. W. Grant, M. Landt

Research output: Contribution to journalArticle

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Abstract

Objective: To establish normal values and determine the impact of congenital or acquired heart disease on serum cardiac troponin I (cTnl). Methods: Concentrations of cTnl were measured in two groups of children. Group A represented ambulatory pediatric patients with no apparent cardiac disease (n = 120) and patients in stable condition with known congenital or acquired cardiac abnormalities (n = 96); group B was composed of patients admitted to intensive care units with normal echocardiograms (n = 16), with abnormal echocardiograms (n = 36), and those with blunt chest trauma who were thought to have cardiac contusions (n = 7). Results: The cTnl concentrations were generally less than 2.0 ng/ml in group A and frequently below the level of detection for the assay (1.5 ng/ml). There was no statistical difference between the two outpatient subgroups (p = 0.66). Nine intensive care patients had cTnl values greater than 2.0 ng/ml. Six of these patients, all with abnormal echocardiograms, had values less than 7.7 ng/ml. All improved and had subsequent normal cTnl concentrations. None of the three remaining patients (two with systemic illness (trauma and Sepsis) and one with severe pulmonary hypertension), all with values greater than 8.0 ng/ml, survived. Three of the four patients with high likelihood of cardiac contusion had cTnl concentrations greater than 2.0 ng/ml (including one patient who died). Conclusions: Cardiac troponin-I values are generally not elevated in children with stable cardiac disease or general pediatric conditions. In the context of severe acute illness, significant elevation of cTnl may be an indicator of poor outcome. Elevation of cTnl may also have diagnostic value in cases when cardiac contusion is suspected.

Original languageEnglish (US)
Pages (from-to)872-877
Number of pages6
JournalJournal of Pediatrics
Volume130
Issue number6
DOIs
StatePublished - 1997
Externally publishedYes

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Troponin I
Reference Values
Pediatrics
Wounds and Injuries
Heart Diseases
Critical Care
Pulmonary Hypertension
Intensive Care Units
Sepsis
Outpatients
Thorax
Serum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Cardiac troponin I in pediatrics : Normal values and potential use in the assessment of cardiac injury. / Hirsch, R.; Landt, Y.; Porter, S.; Canter, C. E.; Jaffe, Allan S; Ladenson, J. H.; Grant, J. W.; Landt, M.

In: Journal of Pediatrics, Vol. 130, No. 6, 1997, p. 872-877.

Research output: Contribution to journalArticle

Hirsch, R, Landt, Y, Porter, S, Canter, CE, Jaffe, AS, Ladenson, JH, Grant, JW & Landt, M 1997, 'Cardiac troponin I in pediatrics: Normal values and potential use in the assessment of cardiac injury', Journal of Pediatrics, vol. 130, no. 6, pp. 872-877. https://doi.org/10.1016/S0022-3476(97)70271-3
Hirsch, R. ; Landt, Y. ; Porter, S. ; Canter, C. E. ; Jaffe, Allan S ; Ladenson, J. H. ; Grant, J. W. ; Landt, M. / Cardiac troponin I in pediatrics : Normal values and potential use in the assessment of cardiac injury. In: Journal of Pediatrics. 1997 ; Vol. 130, No. 6. pp. 872-877.
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T2 - Normal values and potential use in the assessment of cardiac injury

AU - Hirsch, R.

AU - Landt, Y.

AU - Porter, S.

AU - Canter, C. E.

AU - Jaffe, Allan S

AU - Ladenson, J. H.

AU - Grant, J. W.

AU - Landt, M.

PY - 1997

Y1 - 1997

N2 - Objective: To establish normal values and determine the impact of congenital or acquired heart disease on serum cardiac troponin I (cTnl). Methods: Concentrations of cTnl were measured in two groups of children. Group A represented ambulatory pediatric patients with no apparent cardiac disease (n = 120) and patients in stable condition with known congenital or acquired cardiac abnormalities (n = 96); group B was composed of patients admitted to intensive care units with normal echocardiograms (n = 16), with abnormal echocardiograms (n = 36), and those with blunt chest trauma who were thought to have cardiac contusions (n = 7). Results: The cTnl concentrations were generally less than 2.0 ng/ml in group A and frequently below the level of detection for the assay (1.5 ng/ml). There was no statistical difference between the two outpatient subgroups (p = 0.66). Nine intensive care patients had cTnl values greater than 2.0 ng/ml. Six of these patients, all with abnormal echocardiograms, had values less than 7.7 ng/ml. All improved and had subsequent normal cTnl concentrations. None of the three remaining patients (two with systemic illness (trauma and Sepsis) and one with severe pulmonary hypertension), all with values greater than 8.0 ng/ml, survived. Three of the four patients with high likelihood of cardiac contusion had cTnl concentrations greater than 2.0 ng/ml (including one patient who died). Conclusions: Cardiac troponin-I values are generally not elevated in children with stable cardiac disease or general pediatric conditions. In the context of severe acute illness, significant elevation of cTnl may be an indicator of poor outcome. Elevation of cTnl may also have diagnostic value in cases when cardiac contusion is suspected.

AB - Objective: To establish normal values and determine the impact of congenital or acquired heart disease on serum cardiac troponin I (cTnl). Methods: Concentrations of cTnl were measured in two groups of children. Group A represented ambulatory pediatric patients with no apparent cardiac disease (n = 120) and patients in stable condition with known congenital or acquired cardiac abnormalities (n = 96); group B was composed of patients admitted to intensive care units with normal echocardiograms (n = 16), with abnormal echocardiograms (n = 36), and those with blunt chest trauma who were thought to have cardiac contusions (n = 7). Results: The cTnl concentrations were generally less than 2.0 ng/ml in group A and frequently below the level of detection for the assay (1.5 ng/ml). There was no statistical difference between the two outpatient subgroups (p = 0.66). Nine intensive care patients had cTnl values greater than 2.0 ng/ml. Six of these patients, all with abnormal echocardiograms, had values less than 7.7 ng/ml. All improved and had subsequent normal cTnl concentrations. None of the three remaining patients (two with systemic illness (trauma and Sepsis) and one with severe pulmonary hypertension), all with values greater than 8.0 ng/ml, survived. Three of the four patients with high likelihood of cardiac contusion had cTnl concentrations greater than 2.0 ng/ml (including one patient who died). Conclusions: Cardiac troponin-I values are generally not elevated in children with stable cardiac disease or general pediatric conditions. In the context of severe acute illness, significant elevation of cTnl may be an indicator of poor outcome. Elevation of cTnl may also have diagnostic value in cases when cardiac contusion is suspected.

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