Circulating cardiac troponin I levels in Kawasaki disease

In addition to the vascular findings of Kawasaki disease (KD), clinical, el ectrocardiographic, and/ or echocardiographic signs of myocarditis are reco gnizable in the acute phase of KD in many patients. The mechanism of myocar ditis and an association with the development of subsequent coronary artery abnormalities in KD is unknown. Previous studies of serum cardiac troponin I (cTnI) measurements in pediatric populations have suggested a possible u tility of measurements in diagnosis and follow-up of KD. We designed a retr ospective study to evaluate cTnI measurements during acute KD and to assess the predictive value of cTnI measurements in acute KD for the subsequent d evelopment of coronary artery abnormalities. Twenty-nine children were stud ied. Group 1 consisted of 15 KD patients who developed coronary artery abno rmalities as detected by transthoracic echocardiographic evaluation. Group 2 consisted of 14 KD patients with persistently normal coronary artery find ings on echocardiograms. A control group consisted of 11 children, none of whom were known to have had clinical findings of KD or myocarditis. The mea n cTnI values for all three groups were lower than the values suggestive of cardiac damage: group 1 = 0.11 +/- 0.16 ng/ml, group 2 = 0.15 +/- 0.34 ng/ ml, and control = 0.04 +/- 0.08 ng/ml. The current study demonstrates that there is no significant elevation of cTnI in KD patients. Additionally, the re is no correlation between cTnI measurements and the finding of myocardit is, as reflected by decreased cardiac function, or the subsequent developme nt of coronary artery abnormalities.