Role of E-selectin for diagnosing myocardial injury in paediatric patients with mycoplasma pneumoniae pneumonia

Ann Clin Biochem. 2017 Jan;54(1):49-54. doi: 10.1177/0004563216631570. Epub 2016 Sep 28.

Abstract

Backgrounds Effects of myocardial injury on E-selectin remain unclear. Thus, we investigated the diagnostic value of E-selectin for myocardial injury in paediatric patients with mycoplasma pneumoniae pneumonia. Methods In this prospective and blinded clinical study, plasma E-selectin, cardiac troponin I, creatine kinase isoenzyme MB, interleukin-6 and tumor necrosis factor alpha concentrations were measured in paediatric patients with mycoplasma pneumoniae pneumonia (MPP group, n = 138). The control group comprised 120 healthy children. The definition of cardiac injury was based on cardiac troponin I or CK-MB (with or possibly without abnormal electrocardiogram evidence). Diagnostic value of E-selectin for myocardial injury was determined by analysing receiver operating characteristic curves. Results Among the 138 mycoplasma pneumoniae pneumonia patients, 40 patients were identified with myocardial injury, while 98 patients were identified without myocardial injury. Plasma E-selectin concentrations were: 40.22 ± 4.80 ng/mL, in patients with myocardial injury; 18.55 ± 2.16 ng/mL, in patients without myocardial injury and 12.39 ± 3.27 ng/mL, in healthy children. For the 40 patients identified with myocardial injury, area under the receiver operating characteristic curve value for plasma E-selectin concentrations was 0.945 (95% CI: 0.899-0.991), and optimal diagnostic cut-off value was 29.93 ng/mL (positive likelihood ratio = 72.5). Conclusion E-selectin was shown to be an effective index for myocardial injury in paediatric patients with mycoplasma pneumoniae pneumonia, and its role in other causes of myocardial injury warrants further investigation.

Keywords: E-selectin; children; diagnostic value; mycoplasma pneumoniae pneumonia; myocardial injury.

MeSH terms

  • Area Under Curve
  • Biomarkers / blood
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Creatine Kinase, MB Form / blood
  • Creatine Kinase, MB Form / genetics
  • E-Selectin / blood*
  • E-Selectin / genetics
  • Electrocardiography
  • Female
  • Gene Expression
  • Heart Injuries / blood
  • Heart Injuries / complications
  • Heart Injuries / diagnosis*
  • Heart Injuries / pathology
  • Humans
  • Infant
  • Interleukin-6 / blood
  • Interleukin-6 / genetics
  • Male
  • Mycoplasma pneumoniae / growth & development
  • Mycoplasma pneumoniae / pathogenicity*
  • Myocardium / metabolism*
  • Myocardium / pathology
  • Pneumonia, Mycoplasma / blood
  • Pneumonia, Mycoplasma / complications
  • Pneumonia, Mycoplasma / diagnosis*
  • Pneumonia, Mycoplasma / pathology
  • Prospective Studies
  • ROC Curve
  • Troponin I / blood
  • Troponin I / genetics
  • Tumor Necrosis Factor-alpha / blood
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Biomarkers
  • E-Selectin
  • IL6 protein, human
  • Interleukin-6
  • SELE protein, human
  • Troponin I
  • Tumor Necrosis Factor-alpha
  • Creatine Kinase, MB Form