Background: Cardiac troponins T (cTnT) and I (cTnI) are well-established markers in detecting myocardial ischemic damage in adults. Perinatal asphyxia is associated with cardiac dysfunction. Objectives: To evaluate serum concentrations of cTnI in asphyxiated neonates and to investigate whether cTnI is correlated with the traditional markers of asphyxia. Methods: Blood samples were collected from 13 asphyxiated neonates (umbilical artery pH <7.18 and either a 1-min Apgar score <4 or a 5-min Apgar score <7) and 39 controls. Data on gestation, birth weight, sex, Apgar scores, mode of delivery, umbilical pH, creatinine, serum activity of aspartate and alanine aminotransferase, and QTc interval were investigated. Results: Median (range) cTnI concentrations were significantly higher in asphyxiated neonates with respect to healthy infants: 0.36 µg/l (0.05–11) versus 0.04 µg/l (0.04–0.06); p < 0.01. In asphyxiated babies, no statistically significant correlations were found between concentrations of cTnI and the other markers of asphyxia. Conclusions: In asphyxiated neonates, cTnI concentrations are higher with respect to healthy infants, suggesting the presence of myocardial damage in this group of high-risk patients. cTnI does not correlate with the traditional markers of asphyxia.

Aims: To measure and compare cardiac troponin I, cardiac troponin T and creatine kinase MB concentrations in the umbilical cord blood of healthy term infants and to investigate the relationship between maternal and neonatal troponin values at birth. Methods: Troponin I, troponin T and creatine kinase MB concentrations were measured from the umbilical cord samples of 85 healthy term neonates and in the blood samples of their respective mothers at birth. Results: Median (interquartile range) umbilical cord concentrations were 0 μg/L (0–0) for troponin I, 0 μg/L (0–0.019) for troponin T and 4.90 μg/L (3.90–6.61) for creatine kinase MB. Troponin I and T concentrations were higher than the detection limit for the assay in 2 (2.3%) and 41 (48.2%) neonates, respectively. Two mothers (2.3%) had cTnT levels above the detection limit; none of them had increased levels of cTnI. Conclusion: Probably owing to differences in expression and assay detection limits, cord blood troponin T concentrations are frequently over the detection limit at birth, while troponin I is mostly undetectable and comparable with that in healthy pregnant women. These cardiac regulatory proteins are of neonatal origin and are not influenced by maternal levels.

Background: Several epidemiological studies reported a significant correlation between low birth weight and cardiovascular disease in adult life. Recent studies showed that an inflammatory response has been associated with the development of atherosclerosis. High-sensitivity C-reactive protein (hs-CRP) has been demonstrated to be a sensitive marker of this inflammatory process giving prognostic information in apparently healthy general population as well as in patients with symptomatic atherosclerosis.We hypothesized that the chronic inflammatory process, involved in the future atherosclerotic injury, could be found during the fetal period. Objectives:To compare umbilical cord hs-CRP concentrations between small-for-gestational-age (SGA) and appropriate-for-gestational age (AGA) neonates. Methods: Concentrations of hs-CRP (Dade Boehring®) were measured in 35 SGA infants (gestational age: mean ± SD, 34.6 ± 3.0 weeks) and in 69 AGA neonates (34.2 ± 3.4 weeks). Neonates with a history of suspected or proven feto-maternal infection were excluded. Results: In SGA infants, hs-CRP concentrations were significantly higher than in AGA neonates: median (range); 0.06 mg/l (0.02–5.53) vs. 0.02 mg/l (0.02–0.55); p = 0.003. Concentrations of hs-CRP were higher than the detection limit (0.04 mg/l) in 25 (71.5%) SGA infants and in 28 (40.6%) AGA neonates (p = 0.002). Conclusions: In SGA infants, hs-CRP concentrations are higher than in AGA neonates suggesting the presence of an inflammatory process in this group of patients during the fetal life. This finding could be involved in the previously reported relationship between low birth weight and cardiovascular disease in adult life.

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High cTnT concentrations in preterm infants with RDS suggest the presence of myocardial damage in this group of high-risk patients.

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BackgroundSerum protein electrophoresis (SPEP) is used to quantify the serum monoclonal component or M-protein, for diagnosis and monitoring of monoclonal gammopathies. Significant imprecision and inaccuracy pose challenges in reporting small M-proteins. Using therapeutic monoclonal antibody-spiked sera and a pooled beta-migrating M-protein, we aimed to assess SPEP limitations and variability across 16 laboratories in three continents.MethodsSera with normal, hypo- or hypergammaglobulinemia were spiked with daratumumab, Dara (cathodal migrating), or elotuzumab, Elo (central-gamma migrating), with concentrations from 0.125 to 10 g/L (n = 62) along with a beta-migrating sample (n = 9). Provided with total protein (reverse biuret, Siemens), laboratories blindly analyzed samples according to their SPEP and immunofixation (IFE) or immunosubtraction (ISUB) standard operating procedures. Sixteen laboratories reported the perpendicular drop (PD) method of gating the M-protein, while 10 used tangent skimming (TS). A mean percent recovery range of 80%–120% was set as acceptable. The inter-laboratory %CV was calculated.ResultsGamma globulin background, migration pattern and concentration all affect the precision and accuracy of quantifying M-proteins by SPEP. As the background increases, imprecision increases and accuracy decreases leading to overestimation of M-protein quantitation especially evident in hypergamma samples, and more prominent with PD. Cathodal migrating M-proteins were associated with less imprecision and higher accuracy compared to central-gamma migrating M-proteins, which is attributed to the increased gamma background contribution in M-proteins migrating in the middle of the gamma fraction. There is greater imprecision and loss of accuracy at lower M-protein concentrations.ConclusionsThis study suggests that quantifying exceedingly low concentrations of M-proteins, although possible, may not yield adequate accuracy and precision between laboratories.

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