The Role of Highly Sensitive Troponin I in Diagnosis and Prognosis of Dilated Cardiomyopathy in Pediatric Age Group

Abstract

The aim of this study, is to evaluate the role of highly sensitive serum troponin I in diagnosis and prognosis of children with dilated cardiomyopathy. This study included 48 children with dilated cardiomyopathy with left ventricular dysfunction, that diagnosed clinically by history, clinical examination ,electrocardiography and echocardiography, including 2D-echocardiography, M-mode and Doppler study. Echocardiography regarded as the corner stone in the diagnosis of dilated cardiomyopathy. Those patient were subdivided to 15 children present with acute heart failure (Acute DCM) (8 female and 7 male), and 33 children who are known cases of dilated cardiomyopathy reported in the cardiology out clinic with chronic cardiac dysfunction (18 female and 15 male),both groups followed for one year with regular clinical, laboratory and echocardiographic evaluation during treatment coarse for cardiac dysfunction , another 48 control healthy child with same age groups involved in the study (25 female and 23male), the age of both patient and control groups ranging from 1month- 12 years. All patient had cardiac dysfunction at the time of attendance . We found that most patient with Dilated cardiomyopathy with acute left ventricular dysfunction had high serum level of highly sensitive troponin I at the time of presentation. Those patients with chronic Dilated , usually had serum troponin above the detectable limit and significantly more than control group. During follow up all patient show to decrease their serum troponin I level with improvement of their cardiac function till reaching normal or nearly normal level if Left ventricular function improved toward normal value, while those remain with left ventricular dysfunction for longer period despite treatment shown to have higher troponin level. This negative relationship between highly sensitive troponin I indicates that the highly sensitive troponin I is important for both diagnosis and prognosis of patient with dilated cardiomyopathy.