Baig Muhammad A, Ali Shaukat, Khan Mutahir U, Rasheed Javeria, Qadir Abdul, Vasavada Balendu C, Khan Ijaz A
Int J Cardiol. 2006 Nov 18;113(3):E109-10. doi: 10.1016/j.ijcard.2006.06.048. Epub 2006 Sep 28.
Cardiac troponin I is released from myocytes in both reversible and irreversible myocardial injury. The changes in myocyte membrane permeability resulting from the injury could be enough for the release of cardiac troponins from the free cytosolic pool of myocytes without structural damage. We report a case of parvovirus B19 myocarditis in a 26-year-old male who developed regional wall motion abnormalities and severe left ventricular systolic dysfunction with elevated serum levels of cardiac troponin I (peak=11.7 ng/ml). Diagnosis of parvovirus myocarditis was confirmed by presence of high titers of parvovirus B19 IgG and identification of parvovirus B19 DNA by polymerase chain reaction. Within a few days of supportive treatment, the regional wall motion abnormalities resolved, the cardiac function recovered, and the elevation in serum cardiac troponin I subsided. This case further denotes the possibility of release of cardiac troponin I in non-ischemic, reversible myocardial injury.
在可逆性和不可逆性心肌损伤中,心肌肌钙蛋白I都会从心肌细胞中释放出来。损伤导致的心肌细胞膜通透性改变可能足以使心肌肌钙蛋白从心肌细胞的游离胞质池中释放出来,而不会造成结构损伤。我们报告了一例26岁男性的细小病毒B19心肌炎病例,该患者出现了节段性室壁运动异常和严重的左心室收缩功能障碍,血清心肌肌钙蛋白I水平升高(峰值=11.7 ng/ml)。通过检测到高滴度的细小病毒B19 IgG以及通过聚合酶链反应鉴定出细小病毒B19 DNA,确诊为细小病毒心肌炎。在进行支持治疗的几天内,节段性室壁运动异常消失,心脏功能恢复,血清心肌肌钙蛋白I水平升高的情况也消退了。该病例进一步表明了在非缺血性、可逆性心肌损伤中释放心肌肌钙蛋白I的可能性。