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Ann Thorac Surg 1998;66:2073-2077
© 1998 The Society of Thoracic Surgeons

Original Articles

Comparison of troponin-I and troponin-T after pediatric cardiovascular operation

Franz F. Immer, MDa, Franco P. Stocker, MDa, Andrea M. Seiler, MDa, Jean-Pierre Pfammatter, MDa, Gerhardt Printzen, MDb, Thierry P. Carrel, MDc

a Division of Pediatric Cardiology, University Hospital, Berne, Switzerland
b Department of Clinical Chemistry, University Hospital, Berne, Switzerland
c Department of Cardiovascular Surgery, University Hospital, Berne, Switzerland

Accepted for publication May 19, 1998.

Address reprint requests to Dr Stocker, Division of Pediatric Cardiology, University Hospital, 3010 Berne, Switzerland

Background. Although the diagnostic value of troponin-T in childhood is documented, little is known about the significance of troponin-I. It was the aim of this study to compare the diagnostic value of troponin-I and troponin-T in children and newborns to assess the perioperative potential myocardial damage.

Methods. Forty-eight children, mean, 51 ± 54 months (mean value ± 1 standard deviation) (range, 1 day to 204 months) undergoing cardiac operation were prospectively enrolled in the present study. Troponin-I, troponin-T, creatine kinase (CK), and the MB isoenzyme were measured before operation and postoperatively within 2 days.

Results. Postoperative values of troponin-I for children undergoing extracardiac operation were in the normal range. In children with interventions through the right atrium (n = 10) the mean value increase to 6.5 ± 6.1 µg/L (range, 1.8 to 24.3 µg/L) and even to a mean of 29.9 ± 21.1 µg/L (range, 7.5 to 90 µg/L) (p < 0.01) in children with atrial and additional ventricular surgical approach (n = 23). Troponin-I was of equal specificity and sensitivity compared to troponin-T, excepted in patients with postoperative renal failure in whom troponin-T raised to false pathological results.

Conclusions. For detection of perioperative myocardial damage troponin-I shows a higher specificity than CK-MB activity and CK-MB mass. The diagnostic value of troponin-I is similar to troponin-T, but compared with troponin-T, it has the advantage of not being influenced by renal failure.




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