Correlations between high sensitive troponin I and acute myocarditis extent in cardiac magnetic resonance imaging

Abstract

PurposeTo assess the correlation between high sensitive troponin I (HsTnI) levels and myocardial damage on cardiac magnetic resonance (CMR) represented by late gadolinium enhancement (LGE) percentage in patients diagnosed with myocarditis.MethodsRetrospective analysis of consecutive patients who underwent CMR following a suspected diagnosis of acute myocarditis, comparing CMR findings viewed as LGE percentage and HsTnI levels.ResultsBetween February 2016 and December 2021, 101 patients underwent CMR for suspected myocarditis in Rambam Medical Center. Seventy-six (75.2%) patients with a documented diagnosis of acute myocarditis in the medical records based on clinical history and lab work were included in the final analysis. The median age was 30 years [interquartile range (IQR) 22,42] and 62 patients (81.6%) were male. Thirty-four patients (44.7%) had a history of fever and 26 (34.2%) had upper respiratory tract symptoms. The median maximal HsTnI was 3935 ng/l (1165,10 380) and the median C-reactive protein (CRP) was 7.97 mg/l (2.35,19.28). The median LGE percentage was 4.65% (2.6,8.5) and ventricular ejection fraction 60% (56.00,64.75).Linear association was found between LGE (%) and maximal HsTnI (ng/l) value with r = 0.49 (P < 0.001). After including only patients in whom the CMR was performed within 5 days of the maximal HsTnI the correlation improved to r = 0.67 (P < 0.001).ConclusionsHsTnI is an indicator for myocardial damage extent resulting from inflammation in patients with acute myocarditis.

Cardiac Troponin Serum Concentration Measurement Is Useful Not Only in the Diagnosis of Acute Cardiovascular Events

“…Ischemic myocardial damage may also result from disproportions between oxygen supply and demand due to conditions such as bradyarrhythmia [ 60 ], tachyarrhythmia [ 61 ], poorly controlled hypertension resulting in left ventricular hypertrophy [ 62 ], respiratory failure [ 63 ], hypotension [ 64 ], shock (different types, both cardiogenic and non-cardiogenic) [ 65 , 66 , 67 ], or severe anemia [ 68 ]. Moreover, important diseases in which elevated cardiac troponin levels are observed include heart failure [ 69 , 70 , 71 ], myocarditis [ 72 , 73 ], and chronic renal failure [ 74 , 75 ].…”