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Troponin T elevation in lobar lung disease
  1. O M P Jolobe
  1. Department of Adult Medicine, Tameside General Hospital, Fountain Street, Ashton under Lyne OL6 9RW, UK

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    Troponin T blood concentrations are raised, not only in lobar pneumonia,1 but also in submassive pulmonary embolism.2 I hypothesise that this phenomenon is mediated by endothelial damage in the pulmonary vasculature, which has an abundance of angiotensin converting enzyme (ACE).3 Derangements in the renin/angiotensin/aldosterone system (RAAS), in which ACE plays a pivotal part, may, in turn, affect troponin blood concentrations, given the interdependence between the RAAS and troponin release.4 The latter was exemplified by a study documenting the inhibition of troponin release as a result of ACE blockade in patients with acute coronary syndromes characterised by non-ST segment elevation.4