Myocardial injury in children with respiratory syncytial virus infection

Abstract

A large percentage of children admitted to the PICU with RSV infection have myocardial damage as detected by the use of commercially available troponin assays. Additionally, in a portion of these patients, this damage is clinically significant, leading to cardiovascular instability and the need for inotropic support.

Impact of Acute Bronchiolitis on Cardiac Functions and Serum microRNA-122 and 499

“…Increased serum level of cTp I in severe group of the present study is in line with previous studies that demonstrated elevation in cTp I in RSV bronchiolitis (Checchia et al, 2000;Moynihan et al, 2003). Initially, increased levels of cTp I were presumed to be due to myocardial necrosis, as happens in myocardial infarction (Martins et al, 2009).…”

“…It is the only known molecular marker of myocardial injury and is detectable within 6 h of the damage (Thiru et al, 2000). A number of studies have suggested a possible association between cTp I and myocardial injury in patients with non-cardiac diseases (Khan et al, 1999;ver Elst et al, 2000;Checchia et al, 2000;Ammann et al, 2001). Gurkan et al (2004) reported that the relationship between cTp I as a marker of cell death and myocardial function suggests that "cell death" may have a role in the pathogenesis of myocardial dysfunction in septicaemia.…”

Changes in cardiac output and stroke volume as measured by non-invasive CO monitoring in infants with RSV bronchiolitis

“…The following data were obtained from the medical records: (1) Patient demographics including age (months), gender, weight (kg) and length (cm); (2) duration of illness prior to admission; (3) vital signs including HR (beats/ min), systolic and diastolic arterial pressure (SAP and DAP; mmHg), RR (breaths per min) and oxygen saturation (SpO 2 ; % oxygen saturations) and (4) medical interventions including the amount of fluid boluses received during the first 24 h. A 6-h average of vital signs was obtained at the following time intervals: (1) acute stabilization was defined as the first 6 h after arrival to the hospital (2) Initial was the 6 h centered about the Initial CO recording (3) Final was the 6 h centered about Final CO recording and (4) Discharge was defined as the 6 h prior to leaving the hospital. Vital signs measurements were performed using an IntelliVue MP90 Monitor (Philips Electronics N.V.).…”

“…In most cases these infants are admitted to the hospital for respiratory distress and hypoxia; however, RSV has been reported to produce myocarditis [2] or is associated with myocardial injury [3], arrhythmias [4,5], and viral-induced sepsis [6]. Infants with respiratory insufficiency from bronchiolitis may have similar clinical features to infants with congestive heart failure [7], presenting with irritability, fever, tachypnea, tachycardia and a mottled appearance.…”

Cord Blood Cardiac Troponin T and Troponin I Levels in Multiple-Gestation Neonates

“…Interestingly, recent studies showed that troponin I and T measurements could have a role also in situations where the evaluation of risk and degree of cardiac involvement is difficult, such as in respiratory syncytial virus infection [4] and in cases of unexplained intrauterine fetal growth restriction [5] or death [6]. These latter conditions, [7] along with perinatal hypoxic risk [8] and in utero ischemic damage [9], are more frequently found in multiple gestations and could explain the higher mortality and morbidity rates found in twins with respect to singleton pregnancies.…”