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Heart Failure Reviews

Erschienen in:

02.06.2016

Cardiac injury biomarkers in paediatric age: Are we there yet?

verfasst von: Ana L. Neves, Tiago Henriques-Coelho, Adelino Leite-Moreira, José C. Areias

Erschienen in: Heart Failure Reviews | Ausgabe 6/2016

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Abstract

The aim of this article is to evaluate the clinical utility of cardiac injury biomarkers in paediatric age. In December 2015, a literature search was performed (PubMed access to MEDLINE citations; http://www.ncbi.nlm.nih.gov/PubMed/). The search strategy included the following medical subject headings and text terms for the key words: “cardiac injury biomarkers”, “creatine kinase-MB”, “myoglobin”, “troponin”, “children”, “neonate/s”, “newborn/s”, “infant/s” and echocardiography. In the paediatric population, troponins show a good correlation with the extent of myocardial damage following cardiac surgery and cardiotoxic medication and can be used as predictors of subsequent cardiac recovery and mortality. Elevation of cardiac injury biomarkers may also have diagnostic value in cases when cardiac contusion or pericarditis is suspected. Cardiac injury biomarkers are very sensitive markers for the detection of myocardial injury and have been studied in healthy newborns, after tocolysis, intrauterine growth restriction, respiratory distress and asphyxia. The proportion of newborns with elevated troponin was higher than that in ill infants, children, and adolescents and in healthy adults, suggesting that myocardial injury, although clinically occult, is common in this young age group. Results suggest that significant elevation of cord troponin is an excellent early predictor of severity of hypoxic-ischaemic encephalopathy and mortality in term infants. Cardiac biomarkers may also benefit centres without on-site echocardiography with evidence showing good correlation with echo-derived markers of myocardial function. Further studies are needed to better clarify the role of cardiac biomarkers in paediatric age and their correlation with echocardiographic parameters.

Thygesen K, Alpert JS, White HD, Joint ESCAAHAWHFTFftRoMI (2007) Universal definition of myocardial infarction. J Am Coll Cardiol 50(22):2173–2195. doi:10.1016/j.jacc.2007.09.011 PubMedCrossRef

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Writing Group on the Joint ESCAAHAWHFTFftUDoMI, Thygesen K, Alpert JS, White HD, Jaffe AS, Katus HA, Apple FS, Lindahl B, Morrow DA, Chaitman BA, Clemmensen PM, Johanson P, Hod H, Underwood R, Bax JJ, Bonow RO, Pinto F, Gibbons RJ, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasche P, Ravkilde J, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Simoons ML, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S, Guidelines ESCCfP (2012) Third universal definition of myocardial infarction. Eur Heart J 33(20):2551–2567. doi:10.1093/eurheartj/ehs184 PubMedCrossRef

Coudrey L (1998) The troponins. Arch Intern Med 158(11):1173–1180PubMedCrossRef

Ebashi S, Ebashi F (1964) A new protein component participating in the superprecipitation of myosin B. J Biochem 55:604–613PubMed

Ebashi S, Ebashi F (1964) A new protein factor promoting contraction of actomyosin. Nature 203:645–646PubMedCrossRef

Sasse S, Brand NJ, Kyprianou P, Dhoot GK, Wade R, Arai M, Periasamy M, Yacoub MH, Barton PJ (1993) Troponin I gene expression during human cardiac development and in end-stage heart failure. Circ Res 72(5):932–938PubMedCrossRef

Sarko J, Pollack CV Jr (2002) Cardiac troponins. J Emerg Med 23(1):57–65PubMedCrossRef

Sobki SH, Saadeddin SM, Habbab MA (2000) Cardiac markers used in the detection of myocardial injury. http://www.ncbi.nlm.nih.gov/pubmed/11376361. Accessed 21 Sept

Hickman PE, Potter JM, Aroney C, Koerbin G, Southcott E, Wu AH, Roberts MS (2010) Cardiac troponin may be released by ischemia alone, without necrosis. Clin Chim Acta 411(5–6):318–323. doi:10.1016/j.cca.2009.12.009 PubMedCrossRef

10.

Eerola A, Poutanen T, Savukoski T, Pettersson K, Sairanen H, Jokinen E, Pihkala J (2014) Cardiac troponin I, cardiac troponin-specific autoantibodies and natriuretic peptides in children with hypoplastic left heart syndrome. Interact CardioVasc Thorac Surg 18(1):80–85. doi:10.1093/icvts/ivt430 PubMedCrossRef

11.

Kociol RD, Pang PS, Gheorghiade M, Fonarow GC, O’Connor CM, Felker GM (2010) Troponin elevation in heart failure prevalence, mechanisms, and clinical implications. J Am Coll Cardiol 56(14):1071–1078. doi:10.1016/j.jacc.2010.06.016 PubMedCrossRef

12.

Bader D, Kugelman A, Lanir A, Tamir A, Mula E, Riskin A (2006) Cardiac troponin I serum concentrations in newborns: a study and review of the literature. Clin Chim Acta 371(1–2):61–65. doi:10.1016/j.cca.2006.02.018 PubMedCrossRef

13.

Wu AH, Apple FS, Gibler WB, Jesse RL, Warshaw MM, Valdes R Jr (1999) National Academy of Clinical Biochemistry Standards of Laboratory Practice: recommendations for the use of cardiac markers in coronary artery diseases. Clin Chem 45(7):1104–1121PubMed

14.

Antman EM, Tanasijevic MJ, Thompson B, Schactman M, McCabe CH, Cannon CP, Fischer GA, Fung AY, Thompson C, Wybenga D, Braunwald E (1996) Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 335(18):1342–1349. doi:10.1056/NEJM199610313351802 PubMedCrossRef

15.

Immer FF, Stocker F, Seiler AM, Pfammatter JP, Bachmann D, Printzen G, Carrel T (1999) Troponin-I for prediction of early postoperative course after pediatric cardiac surgery. J Am Coll Cardiol 33(6):1719–1723PubMedCrossRef

16.

Bodor GS, Porterfield D, Voss EM, Smith S, Apple FS (1995) Cardiac troponin-I is not expressed in fetal and healthy or diseased adult human skeletal muscle tissue. Clin Chem 41(12 Pt 1):1710–1715PubMed

17.

Mair J, Morandell D, Genser N, Lechleitner P, Dienstl F, Puschendorf B (1995) Equivalent early sensitivities of myoglobin, creatine kinase MB mass, creatine kinase isoform ratios, and cardiac troponins I and T for acute myocardial infarction. Clin Chem 41(9):1266–1272PubMed

18.

Kocylowski RD, Dubiel M, Gudmundsson S, Sieg I, Fritzer E, Alkasi O, Breborowicz GH, von Kaisenberg CS (2009) Biochemical tissue-specific injury markers of the heart and brain in postpartum cord blood. Am J Obstet Gynecol 200(3):273.e1–273.e25. doi:10.1016/j.ajog.2008.10.009 CrossRef

19.

Jaffe AS, Ravkilde J, Roberts R, Naslund U, Apple FS, Galvani M, Katus H (2000) It’s time for a change to a troponin standard. Circulation 102(11):1216–1220PubMedCrossRef

20.

Suleiman MS, Lucchetti V, Caputo M, Angelini GD (1999) Short periods of regional ischaemia and reperfusion provoke release of troponin I from the human hearts. Clin Chim Acta 284(1):25–30PubMedCrossRef

21.

Kogaki S (2011) Highly sensitive cardiac troponin-I in congenital heart disease. Circ J 75(9):2056–2057PubMedCrossRef

22.

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. J Pediatr 130(6):872–877PubMedCrossRef

23.

Soldin SJ, Murthy JN, Agarwalla PK, Ojeifo O, Chea J (1999) Pediatric reference ranges for creatine kinase, CKMB, Troponin I, iron, and cortisol. Clin Biochem 32(1):77–80PubMedCrossRef

24.

Quivers ES, Murthy JN, Soldin SJ (1999) The effect of gestational age, birth weight, and disease on troponin I and creatine kinase MB in the first year of life. Clin Biochem 32(6):419–421PubMedCrossRef

25.

Bailey D, Colantonio D, Kyriakopoulou L, Cohen AH, Chan MK, Armbruster D, Adeli K (2013) Marked biological variance in endocrine and biochemical markers in childhood: establishment of pediatric reference intervals using healthy community children from the CALIPER cohort. Clin Chem 59(9):1393–1405. doi:10.1373/clinchem.2013.204222 PubMedCrossRef

26.

Trevisanuto D, Pitton M, Altinier S, Zaninotto M, Plebani M, Zanardo V (2003) Cardiac troponin I, cardiac troponin T and creatine kinase MB concentrations in umbilical cord blood of healthy term neonates. Acta Paediatr 92(12):1463–1467PubMedCrossRef

27.

Baum H, Hinze A, Bartels P, Neumeier D (2004) Reference values for cardiac troponins T and I in healthy neonates. Clin Biochem 37(12):1079–1082. doi:10.1016/j.clinbiochem.2004.08.003 PubMedCrossRef

28.

Shah A, Feraco AM, Harmon C, Tacy T, Fineman JR, Bernstein HS (2009) Usefulness of various plasma biomarkers for diagnosis of heart failure in children with single ventricle physiology. Am J Cardiol 104(9):1280–1284. doi:10.1016/j.amjcard.2009.06.046 PubMedPubMedCentralCrossRef

29.

Sugimoto M, Ota K, Kajihama A, Nakau K, Manabe H, Kajino H (2011) Volume overload and pressure overload due to left-to-right shunt-induced myocardial injury. Evaluation using a highly sensitive cardiac troponin-I assay in children with congenital heart disease. Circ J 75(9):2213–2219PubMedCrossRef

30.

Korff S, Katus HA, Giannitsis E (2006) Differential diagnosis of elevated troponins. Heart 92(7):987–993. doi:10.1136/hrt.2005.071282 PubMedPubMedCentralCrossRef

31.

Eerola A, Jokinen EO, Savukoski TI, Pettersson KS, Poutanen T, Pihkala JI (2013) Cardiac troponin I in congenital heart defects with pressure or volume overload. Scand Cardiovasc J 47(3):154–159. doi:10.3109/14017431.2012.751506 PubMedCrossRef

32.

Liesemer K, Casper TC, Korgenski K, Menon SC (2012) Use and misuse of serum troponin assays in pediatric practice. Am J Cardiol 110(2):284–289. doi:10.1016/j.amjcard.2012.03.020 PubMedCrossRef

33.

Montgomery VL, Sullivan JE, Buchino JJ (2000) Prognostic value of pre- and postoperative cardiac troponin I measurement in children having cardiac surgery. Pediatr Dev Pathol 3(1):53–60PubMedCrossRef

34.

Taggart DP, Hadjinikolas L, Hooper J, Albert J, Kemp M, Hue D, Yacoub M, Lincoln JC (1997) Effects of age and ischemic times on biochemical evidence of myocardial injury after pediatric cardiac operations. J Thorac Cardiovasc Surg 113(4):728–735PubMedCrossRef

35.

Bottio T, Vida V, Padalino M, Gerosa G, Stellin G (2006) Early and long-term prognostic value of Troponin-I after cardiac surgery in newborns and children. Eur J Cardiothorac Surg 30(2):250–255. doi:10.1016/j.ejcts.2006.05.001 PubMedCrossRef

36.

Imura H, Modi P, Pawade A, Parry AJ, Suleiman MS, Angelini GD, Caputo M (2002) Cardiac troponin I in neonates undergoing the arterial switch operation. Ann Thorac Surg 74(6):1998–2002PubMedCrossRef

37.

Bojan M, Peperstraete H, Lilot M, Vicca S, Pouard P, Vouhe P (2012) Early elevation of cardiac troponin I is predictive of short-term outcome in neonates and infants with coronary anomalies or reduced ventricular mass undergoing cardiac surgery. J Thorac Cardiovasc Surg 144(6):1436–1444. doi:10.1016/j.jtcvs.2012.05.034 PubMedCrossRef

38.

Gupta-Malhotra M, Kern JH, Flynn PA, Schiller MS, Quaegebeur JM, Friedman DM (2013) Cardiac troponin I after cardiopulmonary bypass in infants in comparison with older children. Cardiol Young 23(3):431–435. doi:10.1017/S1047951112001163 PubMedCrossRef

39.

Lipshultz SE, Simbre VC 2nd, Hart S, Rifai N, Lipsitz SR, Reubens L, Sinkin RA (2008) Frequency of elevations in markers of cardiomyocyte damage in otherwise healthy newborns. Am J Cardiol 102(6):761–766. doi:10.1016/j.amjcard.2008.04.057 PubMedPubMedCentralCrossRef

40.

Usluer H, Turker G, Gokalp AS (2012) Value of homocysteine levels, troponin I, and score for neonatal acute physiology and perinatal extension II as early predictors of morbidity. Pediatr Int 54(1):104–110PubMedCrossRef

41.

El-Khuffash AF, Molloy EJ (2008) Serum troponin in neonatal intensive care. Neonatology 94(1):1–7. doi:10.1159/000112540 PubMedCrossRef

42.

Araujo K, da Silva J, Sanudo A, Kopelman B (2004) Plasma concentrations of cardiac troponin I in newborn infants. Clin Chem 50(9):1717–1718. doi:10.1373/clinchem.2004.033472 PubMedCrossRef

43.

Turker G, Babaoglu K, Duman C, Gokalp A, Zengin E, Arisoy AE (2004) The effect of blood gas and Apgar score on cord blood cardiac troponin I. J Matern Fetal Neonatal Med 16(5):315–319. doi:10.1080/14767050400017991 PubMedCrossRef

44.

Kajstura J, Mansukhani M, Cheng W, Reiss K, Krajewski S, Reed JC, Quaini F, Sonnenblick EH, Anversa P (1995) Programmed cell death and expression of the protooncogene bcl-2 in myocytes during postnatal maturation of the heart. Exp Cell Res 219(1):110–121. doi:10.1006/excr.1995.1211 PubMedCrossRef

45.

Clark SJ, Newland P, Yoxall CW, Subhedar NV (2006) Sequential cardiac troponin T following delivery and its relationship with myocardial performance in neonates with respiratory distress syndrome. Eur J Pediatr 165(2):87–93. doi:10.1007/s00431-005-0001-3 PubMedCrossRef

46.

Correale M, Nunno L, Ieva R, Rinaldi M, Maffei G, Magaldi R, Di Biase M (2009) Troponin in newborns and pediatric patients. Cardiovasc Hematol Agents Med Chem 7(4):270–278PubMedCrossRef

47.

Trevisanuto D, Doglioni N, Altinier S, Zaninotto M, Plebani M, Zanardo V (2009) Cardiac troponin I at birth is of fetal-neonatal origin. Arch Dis Child Fetal Neonatal Ed 94(6):F464–F466. doi:10.1136/adc.2008.145987 PubMedCrossRef

48.

Turker G, Babaoglu K, Gokalp AS, Sarper N, Zengin E, Arisoy AE (2004) Cord blood cardiac troponin I as an early predictor of short-term outcome in perinatal hypoxia. Biol Neonate 86(2):131–137. doi:10.1159/000079068 PubMedCrossRef

49.

Wei Y, Xu J, Xu T, Fan J, Tao S (2009) Left ventricular systolic function of newborns with asphyxia evaluated by tissue Doppler imaging. Pediatr Cardiol 30(6):741–746. doi:10.1007/s00246-009-9421-6 PubMedCrossRef

50.

Korraa A, Ezzat MH, Bastawy M, Aly H, El-Mazary AA, Abd El-Aziz L (2012) Cardiac troponin I levels and its relation to echocardiographic findings in infants of diabetic mothers. Ital J Pediatr 38:39. doi:10.1186/1824-7288-38-39 PubMedPubMedCentralCrossRef

51.

Oran B, Cam L, Baspinar O, Baysal T, Reisli I, Peru H, Karaaslan S, Koc H, Gurbilek M (2003) Cardiac troponin-I in the serum of infants of diabetic mothers. Cardiol Young 13(3):248–252PubMed

52.

Simovic AM, Prijic SM, Knezevic JB, Igrutinovic ZR, Vujic AJ, Kosutic J (2014) Predictive value of biochemical, echocardiographic and electrocardiographic markers in non-surviving and surviving asphyxiated full-term newborns. Turk J Pediatr 56(3):243–249PubMed

53.

Vijlbrief DC, Benders MJ, Kemperman H, van Bel F, de Vries WB (2012) Cardiac biomarkers as indicators of hemodynamic adaptation during postasphyxial hypothermia treatment. Neonatology 102(4):243–248. doi:10.1159/000339117 PubMedCrossRef

54.

Szymankiewicz M, Matuszczak-Wleklak M, Vidyasagar D, Gadzinowski J (2006) Retrospective diagnosis of hypoxic myocardial injury in premature newborns. J Perinat Med 34(3):220–225. doi:10.1515/JPM.2006.040 PubMedCrossRef

55.

Boo NY, Hafidz H, Nawawi HM, Cheah FC, Fadzil YJ, Abdul-Aziz BB, Ismail Z (2005) Comparison of serum cardiac troponin T and creatine kinase MB isoenzyme mass concentrations in asphyxiated term infants during the first 48 h of life. J Paediatr Child Health 41(7):331–337. doi:10.1111/j.1440-1754.2005.00626.x PubMedCrossRef

56.

Sadoh WE, Eregie CO, Nwaneri DU, Sadoh AE (2014) The diagnostic value of both troponin T and creatinine kinase isoenzyme (CK-MB) in detecting combined renal and myocardial injuries in asphyxiated infants. PLoS One 9(3):e91338. doi:10.1371/journal.pone.0091338 PubMedPubMedCentralCrossRef

57.

Llurba E, Sanchez O, Ferrer Q, Nicolaides KH, Ruiz A, Dominguez C, Sanchez-de-Toledo J, Garcia-Garcia B, Soro G, Arevalo S, Goya M, Suy A, Perez-Hoyos S, Alijotas-Reig J, Carreras E, Cabero L (2014) Maternal and foetal angiogenic imbalance in congenital heart defects. Eur Heart J 35(11):701–707. doi:10.1093/eurheartj/eht389 PubMedCrossRef

58.

Saxena A, Izmirly PM, Han SW, Briassouli P, Rivera TL, Zhong H, Friedman DM, Clancy RM, Buyon JP (2015) Serum biomarkers of inflammation, fibrosis, and cardiac function in facilitating diagnosis, prognosis, and treatment of anti-SSA/Ro-associated cardiac neonatal lupus. J Am Coll Cardiol 66(8):930–939. doi:10.1016/j.jacc.2015.06.1088 PubMedPubMedCentralCrossRef

59.

Fleming SM, O’Gorman T, Finn J, Grimes H, Daly K, Morrison JJ (2000) Cardiac troponin I in pre-eclampsia and gestational hypertension. BJOG 107(11):1417–1420PubMedCrossRef

60.

Mahajan VS, Jarolim P (2011) How to interpret elevated cardiac troponin levels. Circulation 124(21):2350–2354. doi:10.1161/CIRCULATIONAHA.111.023697 PubMedCrossRef

61.

Sliwa K, Hilfiker-Kleiner D (2015) Cord blood samples: a less explored tool in early diagnosis of neonatal cardiovascular disease. J Am Coll Cardiol 66(8):940–942. doi:10.1016/j.jacc.2015.07.001 PubMedCrossRef

62.

Trevisanuto D, Pitton M, Doglioni N, Altinier S, Zaninotto M, Plebani M, Zanardo V (2004) Cord blood cardiac troponin T and troponin I levels in multiple-gestation neonates. Biol Neonate 85(4):269–272. doi:10.1159/000076365 PubMedCrossRef

63.

Iacovidou N, Boutsikou M, Gourgiotis D, Briana DD, Baka S, Vraila VM, Kontara L, Hassiakos D, Malamitsi-Puchner A (2007) Perinatal changes of cardiac troponin-I in normal and intrauterine growth-restricted pregnancies. Mediat Inflamm 2007:53921. doi:10.1155/2007/53921 CrossRef

64.

Vijlbrief DC, Benders MJ, Kemperman H, van Bel F, de Vries WB (2012) Use of cardiac biomarkers in neonatology. Pediatr Res 72(4):337–343. doi:10.1038/pr.2012.88 PubMedCrossRef

65.

Gaze DC, Collinson PO (2005) Cardiac troponin I should be interpreted with caution in paediatric neonatal patients. Concerning Turker et al.: ‘Cord blood cardiac troponin I as an early predictor of short-term outcome in perinatal hypoxia’. Biol Neonate 87(1):19. doi:10.1159/000080890 PubMedCrossRef

66.

Matter M, Abdel-Hady H, Attia G, Hafez M, Seliem W, Al-Arman M (2010) Myocardial performance in asphyxiated full-term infants assessed by Doppler tissue imaging. Pediatr Cardiol 31(5):634–642. doi:10.1007/s00246-010-9661-5 PubMedCrossRef

67.

Sehgal A, Wong F, Mehta S (2012) Reduced cardiac output and its correlation with coronary blood flow and troponin in asphyxiated infants treated with therapeutic hypothermia. Eur J Pediatr 171(10):1511–1517. doi:10.1007/s00431-012-1764-y PubMedCrossRef

68.

Kozak-Barany A, Jokinen E, Kero P, Tuominen J, Ronnemaa T, Valimaki I (2004) Impaired left ventricular diastolic function in newborn infants of mothers with pregestational or gestational diabetes with good glycemic control. Early Hum Dev 77(1–2):13–22. doi:10.1016/j.earlhumdev.2003.11.006 PubMedCrossRef

69.

El-Khuffash A, Davis PG, Walsh K, Molloy EJ (2008) Cardiac troponin T and N-terminal-pro-B type natriuretic peptide reflect myocardial function in preterm infants. J Perinatol 28(7):482–486. doi:10.1038/jp.2008.21 PubMedCrossRef

70.

Tarkowska A, Furmaga-Jablonska W (2012) The evaluation of diagnostic role of cardiac troponin T (cTnT) in newborns with heart defects. Sci World J 2012:682538. doi:10.1100/2012/682538 CrossRef

71.

Korbling M, Estrov Z (2003) Adult stem cells for tissue repair—a new therapeutic concept? N Engl J Med 349(6):570–582. doi:10.1056/NEJMra022361 PubMedCrossRef

72.

Engin Y, Ustun Y, Kurtay G (2002) Cardiac troponin I levels in umbilical cord blood. Int J Gynaecol Obstet 77(3):239–241PubMedCrossRef

73.

McAuliffe F, Mears K, Fleming S, Grimes H, Morrison JJ (2004) Fetal cardiac troponin I in relation to intrapartum events and umbilical artery pH. Am J Perinatol 21(3):147–152. doi:10.1055/s-2004-823775 PubMedCrossRef

Titel: Cardiac injury biomarkers in paediatric age: Are we there yet?
verfasst von: Ana L. Neves
Tiago Henriques-Coelho
Adelino Leite-Moreira
José C. Areias
Publikationsdatum: 02.06.2016
Verlag: Springer US
Erschienen in: Heart Failure Reviews / Ausgabe 6/2016
Print ISSN: 1382-4147
Elektronische ISSN: 1573-7322
DOI: https://doi.org/10.1007/s10741-016-9567-2

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