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Endomyocardial biopsy often fails to show myo-suspected myocarditis. The serum isoforms of troponin T (cTnT) level is a very sensitive mar-ker of myocardial injury and it is elevated even in the absence of myocardial inflamation. We investigated the corelations for myocardial in-jury, virus titers and inflammation in acute viral infection. Using the murine coxsackievirus group B3 (CVB3) myocarditis model, the histopatho-logic findings and virus titers in mouse hearts were compared with the serum cTnT levels mea-sured by ELISA at various time points. Viable infection (8.220.13 log10 PFU/100 mg of heart); they decreased at day 7 and no viable virus was detected from day 14. Myocardial inflamation was minimal at day 3, peaked at day 7 and markedly decreased at day 14. The individual serum TnT levels were significantly increased at day 3 (7.371.46 ng/ml), persisted to day 7 (0.73 0.08 ng/ml), and normalized at day 14. Serum cTnT levels were corelatable with virus titers in the heart (r= 0.744, P< 0.01), with the degrees of inflammation. Using the less myocarditic strain of CVB3, similar relationships were observed between the changes for the serum cTnT levels and the heart virus titers. During the course of viral infection, myocardial injury precedes the pathologic evidence of in-flamation, and the elevated cTnT levels pro-vide evidence of myocardial injury even in the absence of any histologic findings of myocarditis.

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