CARDIAC TROPONIN-T IN ACUTE RHEUMATIC FEVER

Abstract

Objective: Acute rheumatic fever is still one ofthe leading causes of mortality and morbidity dueto heart disease in developing countries. Carditisis the most important manifestation of thedisease and there are still difficulties in diagnosis.Cardiac troponin-T measurement has beenfound to be valuable in recognition of cardiacinjury in various disease states. We investigatedthe cardiac troponin-T levels in patients withacute rheumatic fever and searched for adifference between patients with and withoutcarditis.Methods: The study group consisted of 21patients; 12 were girls and 9 were boys. Theirage ranged between 6-16.5 years(mean±SD=11.9±2.5 yrs). Seven patients hadonly arthritis; 10 patients had both carditis andarthritis; and 4 patients had chorea as clinicaldiagnosis. Echocardiographic examinationshowed aortic and mitral regurgitation in 7, mitralregurgitation in 8 and aortic regurgitation in onepatient. Serum levels of creatin phosphokinase(CK) and MB (CK-MB) fraction and cardiactroponin-T were measured during the diagnosisbefore the initiation of treatment in all patients.None of the patients had clinically overtcongestive heart failure.Results: It was observed that CK and CK-MBlevels were increased in one patient with carditisand arthritis while cardiac troponin-T levels werebelow the measurable levels in all patients.Conclusion: We concluded that cardiactroponin-T measurement has no value indetecting the presence of carditis in rheumaticfever. This may result from absence ofmyocardial necrosis despite the presence ofintense myocardial inflammation.K e y W o r d s : Troponin, Rheumatic fever,Carditis, Echocardiography