Diagnosis of myocarditis and its role in genesis of heart failure in acute rheumatic Fever [study with troponin I and echocardiography]

ABSTRACT

We performed this prospective study using Troponin I and Doppler echocardiography in patients with acute rheumatic fever [R.F]. admitted to our department to assess non clinical markers of myocarditis during R.F and determine whether a myocardial factor plays a significant role in the genesis of heart failure [H.F]. during acute R.F. The total number of patients included in our study was 108 patients with acute RF. Patients were divided into three groupsgroup 1,included patients without clinical signs of carditis n = 27,group 2 included patients with clinical signs of carditis but without signs and symptoms of C.H.F., n = 56 and group 3, included patients with clinical signs of carditis and signs and symptoms of C.H.F, n = 25 Our results demonstrated that there was no statistically significant difference between the 3 groups regarding L. V. systolic function. No patient had abnormal L V. function as assessed by echocardiography in our patient population. All the patients in groups had moderate to severe mitral and or aortic insufliciency as assessed by Doppler. There was no. statistically significant differences for Troponin I blood levels between the three groups. In conclusion, our study did not detect either Troponin elevation or echocardiographic abnormalities suggesting significant myocardial involvement during rheumatic fever. Congestive heart failure was always associated to severe valve regurgitation