Abstract：
Cardiac troponin is commonly used to screen for cardiac diagnoses in pediatric patients, as it is only released by myocardial tissue. There is limited data regarding high-sensitivity troponin T in pediatric populations and its clinical interpretation. We sought to determine how high-sensitivity troponin values are associated with myocarditis diagnosis. High sensitivity troponin levels were reviewed for pediatric patients at our center from February 2022 to February 2023. Basic demographic and presenting data (including age, gender, body mass index), and diagnoses (cardiac diagnosis, including myocarditis, vs non-cardiac) were compared for patients with elevated initial troponin levels (≥ 12 ng/L) vs. those with non-elevated values. Of the 308 patients included, 91 (29.5%) had elevated hs-cTnT and 45 (14.6%) had a cardiac diagnosis, of whom 8 (2.5%) were ultimately diagnosed with acute myocarditis. There was no meaningful difference in demographic characteristics between the elevated and non-elevated hs-cTnT groups. For patients with diagnosis of myocarditis (n = 8), median peak levels were 506.5 ng/L (182.0 to 1184.0) versus 6.0 ng/L (< 6.0 to 13.5) for those with all other diagnoses (n = 300) (p < 0.001). A high sensitivity troponin cut-off value of 90 ng/dL was established for diagnosis of myocarditis, providing high sensitivity (100%) and specificity of (95%).
摘要：
心肌肌钙蛋白通常用于筛查儿科患者的心脏诊断，因为它只由心肌组织释放。关于儿科人群中高敏肌钙蛋白T及其临床解释的数据有限。我们试图确定高敏肌钙蛋白值与心肌炎诊断的相关性。从2022年2月至2023年2月，我们中心对儿科患者的高敏肌钙蛋白水平进行了审查。基本的人口统计和呈现数据(包括年龄，性别,体重指数)，和诊断(心脏诊断，包括心肌炎,与非心脏）比较了初始肌钙蛋白水平升高（≥12ng/L）的患者与那些具有非提升值的。在包括的308名患者中，91例（29.5%）hs-cTnT升高，45例（14.6%）诊断为心脏，其中8人（2.5%）最终被诊断为急性心肌炎。hs-cTnT升高组和非升高组之间的人口统计学特征没有有意义的差异。对于诊断为心肌炎的患者（n=8），所有其他诊断患者(n=300)的中峰水平分别为506.5ng/L(182.0~1184.0)和6.0ng/L(<6.0~13.5)(p<0.001).建立了90ng/dL的高灵敏度肌钙蛋白临界值，用于诊断心肌炎。提供高灵敏度(100%)和特异性(95%)。
