Is Troponin Elevated In Myocarditis?
Myocarditis is a potentially life threatening and an uncommon type of disease, which presents varieties of symptoms in both adults and children. Myocarditis mainly takes place because of viral infection in most of the developed countries. However, it may cause due to other etiologies, such as protozoa infections and bacterial infections, drug reactions, toxins, giant cell myocarditis, autoimmune problems and sarcoidosis.
Acute injury also results in myocyte damages, which in turn triggers the humeral and innate immune system, resulting in various severe forms of inflammation. In most of the patients, immune reaction regulates down in an eventual way to cause easy recovery of the myocardium. However, in a few selected cases, persistent type of myocardial inflammation results in ongoing damage of the myocyte and relentless heart failure in symptomatic form, along with the sudden death of the individual.(1)
Doctors recommend for diagnosis of patients according to the noninvasive images and clinical presentation of the patients. Most of the patients respond to any standard therapy of cardiac failure in a well manner even though in a few severe cases, they indicate heart transplantation or mechanical circulatory type of support. Prognosis in case of acute myocarditis in most of the cases is good excluding the patients suffering from giant cell myocarditis. Along with this, myocarditis in its chronic and persistent form often has a progressive course with response to the immune suppression.
Is Troponin Elevated In Myocarditis?
A large numbers of cardiologists have conducted a research study to access the usage of troponin level i.e. serum cardiac troponin abbreviated as cTnT level as a noninvasive type of indicator for diagnose of acute myocarditis in infants and children. The main objective behind the research study is to calculate the exact cut off level for cTnT to diagnose the problem of acute myocarditis in young athletes and other children.
For this, doctors have recruited pediatric patients with dilated cardiomyopathy or myocarditis and a control group, while they studied medical history, ECG, physical examination, chest roentgenogram, cTnT level and endomyocardial biopsy to conduct the experiment.(2)
Groups To Conduct The Research Study
Research experts have admitted total 43patients suffering from cardiovascular problems due to primary type of myocardial dysfunction. Accordingly-
- Group 1 consists of 24 patients underwent diagnose with acute myocarditis,
- Group 2 has 19 patients experienced idiopathic chronic type of dilated cardiomyopathy
- Group 3 has 21 patients dealt with moderate to large forms of ventricular septal defect combined with congestive heart failure.(2)
Results Of The Experiment/Research Study
Median value of cTnT level was high in Group 1 as compared to Group 2 and Group 3 patients. On the other side, the Z score and ejection fraction in case of acute myocarditis were in the range of 1.3percent, while from 38percent to 39percent respectively. Indeed, other results were better as compared to dilated cardiomyopathy patients. This is because; DCM patients have only 28 percent of ejection fraction and Z score equal to 6% only.(2)
Conclusion From The Research Study
The research study has shown that the other two parameters i.e. Z score and EF failed to explain any significant effect associated with the outcome of acute myocarditis or dilated cardiomyopathy patients. However, the cutoff point obtained in case of cTnT level was equal to 0.052 ng per milliliter with 86percent of specificity and 71percent of sensitivity. Considering the mentioned statistics, research study has proved that cTnT level equal to 0.052ng per milliliter is a suitable cut off point to diagnose the problem of acute myocardititis. Therefore, the troponin level elevates in case a person suffers from myocarditis.