Cardiac enzyme levels in myocardial dysfunction in newborns with perinatal asphyxia

Rajakumar, Perumal; Bhat, B. Vishnu; Sridhar, Magadi Gopalakrishna; Balachander, J.; Konar, B C; Parameswaran, Narayanan; Chetan, G.

doi:10.1007/s12098-008-0242-z

Cited by 39 publications

(42 citation statements)

References 8 publications

(6 reference statements)

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“…11 There was a linear relation between the severity of asphyxia as assessed by HIE grading and the CK-MB values. The Percentage of babies with grade three HIE was similar to Rajkumar PS et al, Karnik E et al whereas HIE grade 3 was higher in Jyoti et al 10,12,13 In present study, there was no significant difference in CK-MB values between HIE 1 and 2, whereas between HIE 1 and 3 the rise was statistically significant showing that evaluation of enzymes can be a good tool to assess the severity of HIE. In a study conducted by Merchant S et al also there was a significant difference between HIE1 and 3 ( Table 8).…”

Section: Asphyxia and Hiesupporting

confidence: 83%

“…The ECG changes observed in asphyxiated babies is similar to those observed in Rajkumar PS et al, except that in their study, Grade 2 changes were more. 10 As per Rowe classification Grade 1 and 2 changes are equivocal or suggestive, which is less significant. In Jyoti et al, the ECG changes were classified based on Jedikien classification and Grade 1 changes which are nonspecific.…”

Section: Ecg Changesmentioning

confidence: 98%

“…10,12,13 This may be due to great variation in Twave changes in normal babies in the first week of life. The ECG changes observed in asphyxiated babies is similar to those observed in Rajkumar PS et al, except that in their study, Grade 2 changes were more.…”

Section: Ecg Changesmentioning

confidence: 99%

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A biochemical profile of cardiac involvement in perinatal asphyxia

Kumar¹,

Arasan²

2018

Int J Contemp Pediatr

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Background: Perinatal hypoxia is one of the leading causes of mortality and morbidity in developing countries like India, and even in developed countries. Perinatal hypoxia can result in Transient myocardial ischemia, tricuspid and mitral regurgitation, myocardial infarction, cardiac failure. The measurement of Creatine kinase -MB isoenzyme a cardiac specific enzyme helps in assessing the degree of myocardial involvement in asphyxiated infants.Methods: A Prospective case-control study was done in a Tertiary care centre serving rural areas predominantly, to determine the cardiac involvement by measuring serum MB isoenzyme of creatine kinase in perinatally asphyxiated inborn term babies for a period of six months.Results: There was a significant difference in the CK-MB values with regard to weight in both cases and controls. The mean CK-MB levels were higher in babies who had assisted delivery (forceps and breech) than those delivered by labour natural and LSCS. Mean CK-MB values of asphyxiated and controls were 133.8u/l and 27.12 u/l respectively with a p value of < 0.01. There was a significant difference between HIE1 and 3 with a p value of<0.02. Out of 60 cases 28 had abnormal ECG findings (46.6%). Statistically significant difference was found in the mean CK-MB between the normal and Grade4 ECG changes group. The overall predictive accuracy of CK-MB is high in Perinatal asphyxia (88%), Cardiac involvement (83%), Mortality (83%) and a moderate predictive accuracy for HIE (75%).Conclusions: Cardiac abnormalities in asphyxiated neonates are often underdiagnosed and requires high index of suspicion. Cardiac specific enzyme CK-MB helps in early recognition of myocardial damage and better management of cases, would reduce the neonatal mortality and morbidity. An expectant eye can be kept for complications in babies with markedly elevated CK-MB enzyme.

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Section: Asphyxia and Hiesupporting

confidence: 83%

Section: Ecg Changesmentioning

confidence: 98%

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A biochemical profile of cardiac involvement in perinatal asphyxia

Kumar¹,

Arasan²

2018

Int J Contemp Pediatr

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“…The predominant features of cardiac dysfunction were respiratory distress (53.3%), shock (48.3%) and congestive heart failure 9 (1.7%) in our study. Rajakumar et al 4 found respiratory distress (66.7%), cardiac failure (36.7%) and cardiogenic shock in 5 (16.7%) neonates in their study. The proportion of neonates having shock in our study is comparable with the fi nding of Mandal et al (44%) 15 .…”

Section: Discussionmentioning

confidence: 61%

“…Perinatal asphyxia is a common problem with the incidence varying from 0.5 -2% of live births [1][2][3][4] . It is an important cause of neonatal mortality and is a frequent cause for admission to neonatal intensive care units (NICU).…”

Section: Introductionmentioning

confidence: 99%

Clinico-Biochemical Profile of Neonates with Birth Asphyxia in Eastern Nepal

Shah

Agrawal

Mishra

et al. 2013

J. Nepal Paedtr. Soc.

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Introduction: Perinatal asphyxia is a common problem with the incidence varying from 0.5 -2% of live births. It is an important cause of neonatal mortality and is a frequent cause for admission to neonatal intensive care units (NICU). The aims of this study were to find out the clinical and biochemical alterations in different stages of HIE. Materials and Methods: This was a prospective hospital based observational study performed during the period of February, 2010 to January, 2011. Results: Sixty inborn neonates satisfying the criteria for birth asphyxia requiring admission to pediatric wards and neonatal intensive care unit were studied. There were 13(21.7%) cases of mild hypoxemic ischemic encephalopathy (HIE), 27 (45%) moderate and 20 (33.3%) severe HIE. Seizures 41(68.3%), respiratory distress 32(53.3%) and shock 29(48.3%) were predominant manifestations observed. Meconium aspiration syndrome was found in 13.3% of neonates. Hypoglycemia 11(18.3%), hypocalcaemia 7(11.7%), hyponetremia 14 (23.3%) and hyperbilirubinemia 9(15%) were associated biochemical abnormalities. Twenty cases (33.3%) had acute renal failure and they belonged to moderate and severe stages of HIE. Seizures (P< 0.001), respiratory distress (P=0.015), shock (P<0.001) and serum creatinine (P=0.004) were found to be significant among different HIE stages. Conclusion: Neonates having birth asphyxia had HIE, seizures, respiratory distress, shock, hypoglycemia hypocalcaemia, hyponetremia, hyperbilirubinemia and acute renal failure mostly in moderate and severe stages

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Myocardial Performance in Asphyxiated Full-Term Infants Assessed by Doppler Tissue Imaging

et al. 2010

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The aim of this study was to assess myocardial performance of full-term infants with perinatal asphyxia using Doppler tissue imaging (DTI) and to correlate it with serum cardiac troponin T (cTnT) concentrations. Twenty-five asphyxiated and 20 nonasphyxiated term infants were investigated. Serum cTnT concentrations were measured between 12 and 24 h of life. Conventional two-dimensional Doppler echocardiography and DTI were done during the first 72 h of life. Right ventricular (RV) and left ventricular (LV) Tei indexes were significantly higher in asphyxiated neonates (mean +/- SD: 0.45 +/- 0.05 vs. 0.28 +/- 0.05, P < 0.001 and 0.51 +/- 0.04 vs. 0.38 +/- 0.04, P < 0.001, respectively). Mitral and tricuspid systolic (Sm) velocities were significantly lower in asphyxiated neonates (mean +/- SD: 5.06 +/- 0.89 vs. 6.89 +/- 0.94 cm/s, P < 0.001 and 5.78 +/- 0.58 vs. 6.69 +/- 0.87 cm/s, P < 0.001, respectively). cTnT concentrations were significantly higher in asphyxiated neonates [median (range): 0.17 (0.05-0.23) vs. 0.03 (0-0.07) microg/l, P < 0.001)], and they correlated positively with the LV Tei index (r = 0.67, P < 0.001) and the RV Tei index (r = 0.68, P < 0.001) and negatively with the mitral systolic (Sm) velocity (r = -0.68, P < 0.001) and tricuspid systolic (Sm) velocity (r = -0.41, P = 0.01). A higher cTnT was a significant predictor of mortality, whereas fractional shortening (FS) and DTI measurements did not show any significant predictive value. The DTI technique appears to be more sensitive than conventional echocardiography in the early detection of myocardial dysfunction induced by perinatal asphyxia in full-term infants.

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Cardiac enzyme levels in myocardial dysfunction in newborns with perinatal asphyxia

Abstract: C-Tropopnin assay is useful in evaluating the severity of myocardial damage and outcome in perinatal asphyxia.

Cited by 39 publications

References 8 publications

A biochemical profile of cardiac involvement in perinatal asphyxia

A biochemical profile of cardiac involvement in perinatal asphyxia

Clinico-Biochemical Profile of Neonates with Birth Asphyxia in Eastern Nepal

Myocardial Performance in Asphyxiated Full-Term Infants Assessed by Doppler Tissue Imaging

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