Publication Name	World Journal of Critical Care Medicine
Manuscript ID	124843
DOI	10.5492/wjccm.124843
Country	Greece

Category	Critical Care Medicine
Manuscript Type	Minireviews
Article Title	Elevated cardiac troponin in acute respiratory distress syndrome: Myocardial dysfunction marker or integrated signal of critical illness severity?
Manuscript Source	Invited Manuscript
All Author List	George Ε Zakynthinos, Ioanna Tzima, Evangelos Oikonomou, Konstantinos Kalogeras, George Makavos, Grigorios Giamouzis, Andrew Xanthopoulos, Gerasimos Siasos, Epaminondas Zakynthinos and Vasiliki Tsolaki
Funding Agency and Grant Number
Corresponding Author	George Ε Zakynthinos, MD, 3rd Department of Cardiology, “Sotiria” Chest Diseases Hospital, Medical School, National and Kapodistrian University of Athens, Mesogion 152, Athens 11527, Greece. gzakynthinos2@gmail.com
Key Words	Troponin; Acute respiratory distress syndrome; COVID-19; Myocardial injury; Echocardiography; Right ventricular dysfunction; Critical illness; Sepsis; Mechanical ventilation
Core Tip	Troponin elevation in severe acute respiratory distress syndrome (ARDS), especially in coronavirus disease 2019 (COVID-19), should not be simplistically interpreted as synonymous with primary cardiac injury. In most critically ill patients, increased troponin appears to reflect the cumulative burden of systemic inflammation, hypoxemia, pulmonary vascular stress, and multiorgan dysfunction rather than isolated myocardial pump failure. Echocardiographic studies suggest that right ventricular abnormalities are common in COVID-19 ARDS, yet troponin elevation often occurs without a consistent relationship to objective systolic dysfunction. Reframing troponin as a biomarker of global disease severity may improve diagnostic precision, avoid overdiagnosis of myocarditis or cardiac failure, and support more rational use of bedside cardiac imaging in both COVID-19 and non-COVID ARDS.
Citation	Zakynthinos GΕ, Tzima I, Oikonomou E, Kalogeras K, Makavos G, Giamouzis G, Xanthopoulos A, Siasos G, Zakynthinos E, Tsolaki V. Elevated cardiac troponin in acute respiratory distress syndrome: Myocardial dysfunction marker or integrated signal of critical illness severity? World J Crit Care Med 2026; In press DOI: https://doi.org/10.5492/wjccm.124843
PDF	124843-in-press.pdf

Received	2026-06-25 06:34
Peer-Review Started	2026-06-25 06:35
First Decision by Editorial Office Director
Return for Revision	2026-07-09 09:28
Revised	2026-07-22 04:42
Publication Fee Transferred
Second Decision by Editor	2026-09-03 02:51
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-09-04 10:22
Articles in Press	2026-09-04 10:22
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3141(online)
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