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Cardiac troponin-I in the serum of infants of diabetic mothers

Published online by Cambridge University Press:  24 May 2005

Bülent Oran ,
Lokman Çam ,
Osman Başpınar ,
Tamer Baysal ,
İsmail Reisli ,
Harun Peru ,
Sevim Karaaslan ,
Hasan Koç  and
Mehmet Gürbilek
Bülent Oran
Affiliation:
Department of Paediatrics, Meram Medicine Faculty, Selçuk University, Turkey
Lokman Çam
Affiliation:
Department of Paediatrics, Meram Medicine Faculty, Selçuk University, Turkey
Osman Başpınar
Affiliation:
Department of Paediatrics, Meram Medicine Faculty, Selçuk University, Turkey
Tamer Baysal
Affiliation:
Department of Paediatrics, Meram Medicine Faculty, Selçuk University, Turkey
İsmail Reisli
Affiliation:
Department of Paediatrics, Meram Medicine Faculty, Selçuk University, Turkey
Harun Peru
Affiliation:
Department of Paediatrics, Meram Medicine Faculty, Selçuk University, Turkey
Sevim Karaaslan
Affiliation:
Department of Biochemistry, Meram Medicine Faculty, Selçuk University, Turkey
Hasan Koç
Affiliation:
Department of Paediatrics, Meram Medicine Faculty, Selçuk University, Turkey
Mehmet Gürbilek
Affiliation:
Department of Biochemistry, Meram Medicine Faculty, Selçuk University, Turkey
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Abstract

A transient form of hypertrophic cardiomyopathy has been previously described in infants of diabetic mothers. When it occurs, it is generally benign. The purpose of our study was to establish the extent of injury to the cardiomyocytes in symptomatic and asymptomatic patients with and without hypertrophic cardiomyopathy.

Thus, we compared 35 consecutive patients to 20 healthy controls, establishing the significance, if any, of differences in cardiac troponin-I and creatine kinase, including its MB-fraction, and seeking to establish the value of these parameters in the diagnosis of cardiac injury. We also determined to levels of glucose and insulin in the serum, and took note of electrocardiographic and echocardiographic investigations. Values were determined at the 1st and 7th days after admission in the patients, while parameters were measured in the control group only on the first day.

We found that the levels of cardiac troponin-I in the serum, known to be a marker for cardiac injury, were significantly elevated in symptomatic patients with life-threatening respiratory or haemodynamic distress. We speculate that transient ventricular hypertrophy is neither the cause nor the consequence of damage to the cardiomyocytes. It would be interesting, nonetheless, to determine the relationship, if any, between cardiomyocytic damage and clinical outcome.

Keywords

Infants of diabetic mothershypertrophic cardiomyopathycardiac troponin-Icreatine kinasecreatine kinase-MB
Type
Original Article
Information
Cardiology in the Young , Volume 13 , Issue 3 , June 2003 , pp. 248 - 252
Copyright
© 2003 Cambridge University Press

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References

Gutgesell HP, Speer ME, Rosenberg HS. Characterization of the cardiomyopathy in infants of diabetic mothers. Circulation 1980; 61: 441–450.Google Scholar
Henry WY, Clarc CE, Epstein SE. Asymmetric septal hypertrophy: Echocardiographic identification of the patognomonic anatomic abnormality of IHSS. Circulation 1973; 47: 225–233.Google Scholar
World Health Organization: Definition, Diagnosis and Classification of Diabetes: Mellitus and its Complications. Part 1: Diagnosis and Classification of Diabetes Mellitus. Department of Noncommunicable Disease Surveillance, Geneva, 1999.
Feigenbaum H. Echocardiography. Lea & Febiger, Philadelphia, 1994, pp 658–675.
Henry WL, Ware J, Gardin JM, Hepner SI, McKay J, Weiner M. Echocardiographic measurements in normal subjects. Growth-related changes that occur between infancy and early adulthood. Circulation 1978; 57: 278–285.Google Scholar
Stoll BJ, Kliegman RM. The fetus and the neonatal infant. In: Behrman RE, Kliegman RM, Jenson HB (eds). Nelson Textbook of Pediatrics, 16th edn. W.B. Saunders Company, Philadelphia, 2000, pp 532–533.
Caddell JL. Metabolic and nutritional disease and diseases in the tropics. In: Allen HD, Gutgesell HP, Clark EB, Driscoll DJ (eds). Moss and Adams' Heart Disease in Infant, Children and Adolescent, 6th edn. Lippincott Williams & Wilkins Company, Philadelphia, 2001, pp 1257–1258.
Wu AHB, Valdes R Jr, Apple FS, Gornet T, Stone MA, Mayfield-Stokes S. Cardiac troponin T immunoassay for diagnosis of acute myocardial infarction. Clin Chem 1994; 40: 900–907.Google Scholar
Galvani M, Ottani F, Ferrini D, Ladenson JH, Destro A, Baccos D. Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina. Circulation 1997; 95: 2053–2059.Google Scholar
Smith SC, Ladenson JH, Mason JW, Jaffe AS. Elevations of cardiac troponin I associated with myocarditis: experimental and clinical correlates. Circulation 1997; 95: 163–168.Google Scholar
Adams JE, Davilla-Roman VG, Bessey P, Blake DP, Ladenson JH, Jaffe AS. Improved detection of cardiac contusion with cardiac troponin I. Am Heart J 1996; 131: 308–312.Google Scholar
La Wu AH, Apple FS, Gibler WB. National Academy of Clinical Biochemistry standards of laboratory practice: recommendations for the use of cardiac markers in coronary artery diseases. Clin Chem 1999; 45: 1104–1121.Google Scholar
Spies C, Haude V, Fitzner R, et al. Serum cardiac troponin T as a prognostic marker in early sepsis. Chest 1998; 113: 1055–1063.Google Scholar
Missov E, Calzolari C, Pau B. Circulating cardiac troponin I in severe congestive heart failure. Circulation 1997; 96: 2953–2958.Google Scholar
La Vecchia L, Mezzena G, Ometto R, et al. Detectable serum troponin I in patients with heart failure of non-myocardial ischemic origin. Am J Cardiol 1997; 80: 88–90.Google Scholar
Soldin SJ, Murthy NJ, Agarwalla PK, Ojeifo O, Chea J. Pediatric reference ranges for creatine kinase, CKMB, troponin I, iron, and cortizol. Clin Biochem 1999; 32: 77–80.Google Scholar
Hirsch R, Landt Y, Porter S, Canter CE, Jaffe AS, Ladenson JH. Cardiac troponin I in pediatrics: normal values and potential use in the assessment of cardiac injury. J Pediatr 1997; 130: 872–877.Google Scholar
Ottlinger M, Pearsall L, Rifai N, Lipshultz SE. New developments in the biochemical assessment of myocardial injury in children: Troponin T and I as highly sensitive and specific markers of myocardial injury. Prog Pediatr Cardiol 1998; 8: 71–81.Google Scholar
Adams JE, Bodor GS, Davilla-Roman VG, et al. Cardiac troponin I: a marker with high specificity for cardiac injury. Circulation 1993; 88: 101–106.Google Scholar