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Initial Tn levels were elevated (21.8 11.9 ng/dl) in the patient group. The absolute level of Tn could
not differentiate patients who would survive or not. Nevertheless, daily Tn level over the first 72
hours clearly showed that patients with a steep decline in Tn (6.53 3.73, ranged from 2.494 to
14.8, n 13) were able to be weaned off mechanical support (Figure 1). This finding may suggest
that initially high Tn values do not necessarily indicate irreversible damage to the myocardium;
rather, rapid decline in Tn slope may reflect early recovery of the myocardium. Conversely, initial
Tn levels, even if not particularly elevated, might reflect irreversible damage of the myocardium
without good prospects for recovery if they remain persistently elevated.
Figure 1. Trend of daily troponin
(Tn) levels.
Patients 1 to 5 used Tn T, and the
others used Tn I. There are similarities
in the slope in reversible fulminant
myocarditis, 6.53 3.73 ng/ml/day (n
13;
patient 12 with failed weaning and
patient 10 with only one Tn datum
were excluded from analysis).