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Role of serum cardiac troponin T in the diagnosis of acute rheumatic fever and rheumatic carditis
  1. D Alehan,
  2. C Ayabakan*,
  3. O Hallioglu
  1. Department of Pediatric Cardiology, Pediatric Cardiology Unit, Hacettepe University, İhsan Doğramacı Children’s Hospital, Ankara, Turkey
  1. Correspondence to:
    Dr Canan Ayabakan
    Altunizade mah. Atıf Bey sok, No: 65/8 Üsküdar 34718, İstanbul, Turkey; cayabakanyahoo.com

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The incidence of acute rheumatic fever (ARF) has declined in industrialised countries since the 1950s. In developing countries, it remains an endemic disease of school aged children and is a major cause of cardiovascular morbidity and mortality. Cardiac troponin T (cTnT) is a highly sensitive and specific marker of cardiomyocyte damage.1 In this study, we attempted to assess the role of serum cTnT values in the documentation of cardiac damage in ARF patients with and without carditis.

PATIENTS AND METHOD

Forty six consecutive patients (29 males) with ARF diagnosed (according to the modified Jones’ criteria) within two years, were prospectively studied. A new murmur of aortic or mitral regurgitation was considered as clinical evidence of carditis. This was confirmed by echocardiography at the time of the diagnosis. We used the previously established Doppler echocardiographic guidelines to define pathological mitral and aortic insufficiency.2 We also measured left ventricular systolic and diastolic diameters and fractional shortening in parasternal long axis position with M mode echocardiography. Serum cTnT concentrations were determined by using the third generation Elecsys Troponin T STAT immunoassay (Roche Diagnostics Mannheim, Germany), standardised with human recombinant cTnT. The lower detection limit of the assay is 0.01 ng/ml and the normal range for cTnT is 0.01 to 0.1 ng/ml. Serum creatine kinase isoenzyme …

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Footnotes

  • * Also Altunizade mah. Atıf Bey sok, No: 65/8 Üsküdar 34718, İstanbul, Turkey