Cardiac troponin T and myocardial injury during routine cardiac catheterisation in children

Background: This study aims to investigate whether intracardiac catheterization produces myocardial damage on pediatric heart. Methods: Five blood samples were collected (basal, immediate post procedure, at 4, 12 and 24 h after the procedure) for troponin T and creatine kinase MB (CKMB) from 48 consecutive patients (age: 5.34±6.03 years). The effect of age, duration of procedure, pulmonary hypertension, cyanosis, and medication taken for congestive heart failure on the levels of troponin T and CKMB were sought. Results: The increase in CKMB (basal CKMB: 3.93±3.70 ng/ml; peak CKMB: 8.68±10.89 ng/ml; P<0.0001) and troponin levels (basal troponin: 0.002±0.003 ng/ml; peak troponin: 0.11±0.23 ng/ml; P<0.0001) over time was significant in the study group. Additionally younger patients (≤1 year), patients with pulmonary hypertension (mean pulmonary artery pressure >25 mmHg), longer procedure time (>30 min), and patients taking anti-congestive heart failure therapy had significantly higher levels of CKMB and troponin (P>0.05). Conclusion: All patients undergoing cardiac catheterization are under risk of myocardial injury, and younger patients with pulmonary hypertension and especially with compensated cardiac failure have increased risk of myocardial damage, and need to be handled carefully.