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Troponin I And Its Relation To Disease Severity In Paediatric Hypertrophic Cardiomyopathy

Sarah Watson

Hypertrophic cardiomyopathy (HCM) is a genetic disorder that is characterized by left ventricular hypertrophy unexplained by secondary causes, and a non-dilated left ventricle with preserved or increased ejection fraction. It is commonly asymmetric with the most severe hypertrophy involving the basal interventricular septum. Left ventricular outflow tract obstruction is present at rest in about one third of the patients, and can be provoked in another third. The histologic features of HCM include myocyte hypertrophy and disarray, as well as interstitial fibrosis. The hypertrophy is also frequently associated with left ventricular diastolic dysfunction. In the majority of patients, HCM has a relatively benign course. However, HCM is also an important cause of sudden cardiac death, particularly in adolescents and young adults. Nonsustained ventricular tachycardia, syncope, a family history of sudden cardiac death, and severe cardiac hypertrophy are major risk factors for sudden cardiac death. This complication can usually be averted by implantation of a cardioverter-defibrillator in appropriate high-risk patients. Atrial fibrillation is also a common complication and is not well tolerated. Troponin is associated with increased risk of adverse outcomes and correlates with multiple parameters of disease severity in adults with hypertrophic cardiomyopathy (HCM). However, prognostic and staging markers in adults are not always of value in children with HCM. This study assessed the ability of troponin I (TnI) to predict clinical variables in a paediatric cohort of HCM and compare this to well-established biomarker, NT-proBNP.TnI and NT-proBNP were measured in forty-nine patients with HCM [10.69