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Background: Pulmonary arterial hypertension (PAH) is a frequent complication of congenital heart disease (CHD) with left-to-right shunt. Increased pulmonary pressure leads to vascular remodeling and RV dysfunction. Objectives: To analyze the role of high-sensitive cardiac troponin T (hs -cTnT) in the determination of myocardial injury caused by volume and pressure load due to pulmonary hypertension (PH) in children with left to right cardiac shunt. Patients and Methods: Twenty patients with congenital heart disease (CHD) with left to right shunt and PAH-CHD, 20 patients with CHD with left to right shunt but without PH, and 20 healthy children, in total 60 individuals, were included in the study. All cases aged between 3 and 36 months. Plain x-ray chest and heart, electrocardiography, Doppler and Two –dimensional, Mmode echocardiographic evaluation of CHD and pulmonary pressure were performed in all patients. Blood samples were obtained from all cases for measurement of serum high-sensitive cardiac troponin T (hs-cTnT) levels by highly sensitive third-generation quantitative test. Original Research Article El Sameaa et al.; JAMMR, 32(23): 156-163, 2020; Article no.JAMMR.62780 157 Results: The mean hs-cTnT levels were significantly higher in patients with PH than in patients without PH (p < 0.05) with a sensitivity 70% and specificity 95%. A statistically significant positive correlation was determined between pulmonary artery pressure and hs-cTnT levels, and significant negative correlation with EF% and FS %( by echocardiography). Conclusions: Serum levels of high-sensitive cardiac troponin T (hs-cTnT) were significantly elevated in PAH-CHD children denoting myocardial injury caused by volume and pressure load due to PH in children with left to right cardiac shunts, so it could be used as a cardiac biomarker in PAH-CHD children with good diagnostic and prognostic value and high sensitivity and specificity, which may be useful in the management of PH in childhood.

Serum High Sensitive Cardiac Troponin-T (hs-cTnT) as a Biomarker in Pediatric Pulmonary Hypertension due to Congenital Left to Right Cardiac Shunt