Serum cardiac troponin as an early predictor of subclinical global myocardial dysfunction in children with chronic renal failure

Abstract EN

Background: Cardiovascular disease is the leading cause of death in chronic renal failure (CRF) patients on dialysis, as well as a leading cause of morbidity.

Pediatric patients are ideal for studies of the relationship between uremia and heart disease because they are unlikely to have cardiac risk factors other than uremia. Patients with uremia often have elevated serum cardiac troponin T (cTnT) even without clinical heart damage.

Serum troponin are the prefered marker for the diagnosis of myocardial injury among patients with chronic renal failure. Aims: To determine the possible relation between cardiac troponin T level and uremia in chronic renal failure patients in Port Said General Hospital. Methods: 35 pediatric patients with chronic renal failure and without clinical heart disease were included in this study who came for follow up or haemodialysis.

Levels of cTnT were tested for correlation with cardiac dysfunction. Myocardial dysfunction was estimated by tei index (myocardial performance index) and blood chemistry were done for all patients. Results: This study revealed that 33 pediatric patients had cardiovascular abnormalities including increased left ventricular function, elevated heart rate and blood pressure, and reduced LV afterload.

LV contractility was inversely correlated with cTnT level.

Higher cTnT also correlated with higher, blood urea nitrogen and bicarbonate levels, and the use of diuretics. Conclusion: In conclusion, Elevated cTnT levels are a good indicators of myocardial dysfunction.

Cardiac damage, indicated by either elevated cTnT or low LV contractility, is related to uremia, deranged calcium and phosphorus metabolism, and bicarbonate levels.

Serum cTnT is a good predictor for early detection of subclinical cardiac damage for chronic renal failure patients.

Early detection of cardiovascular abnormalities in these patients might allow earlier interventions to reduce morbiditv and mortalitv.