Cardiac Troponin I in Asphyxiated Neonates

Trevisanuto, Daniele; Picco, Giorgio; Golin, Rosanna; Doglioni, Nicoletta; Altinier, Sara; Zaninotto, Martina; Zanardo, Vincenzo

doi:10.1159/000089795

Cited by 48 publications

(58 citation statements)

References 39 publications

(33 reference statements)

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“…However, Bodor et al [21] showed that cTnI is exclusive to the myocardium and therefore elevated levels of cTnI must be of cardiac origin. High levels of cTnI were found in this study in perinatal asphyxiated patients, as was found by others as well [6]. The similar cTnI levels at 6 h suggest that the severity of hypoxia-induced cardiac myocyte damage was comparable in both groups.…”

Section: Discussionsupporting

confidence: 91%

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Cardiac Biomarkers as Indicators of Hemodynamic Adaptation during Postasphyxial Hypothermia Treatment

Vijlbrief¹,

Benders²,

Kemperman

et al. 2012

Neonatology

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Background: Little is known about the effects of hypothermia on the cardiovascular system in term newborns with neonatal encephalopathy. Objectives: To evaluate whether mild hypothermia for neonatal encephalopathy is cardioprotective as indicated by the cardiac biomarkers cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP). Methods: This was an observational cohort study of infants treated for perinatal asphyxia. In infants, mild total body hypothermia treatment of 33.5°C during 72 h was initiated (n = 20). Samples of cTnI and BNP were collected before the start of hypothermia, at 24 and 48 h after birth, and after rewarming (84 h). BNP and cTnI values were then compared with BNP and cTnI values of asphyxiated infants not treated with hypothermia (n = 28). Results: No differences were found between the groups in clinical patient characteristics or inotropic support. The hypothermia-treated patients seemed to be clinically more affected (5-min Apgar score, p < 0.05; umbilical artery pH, p = 0.08), but showed similar encephalopathy scores. Significantly lower values for BNP were found in hypothermia- compared to nonhypothermia-treated infants at 48 h and at normothermia after rewarming [144 pmol/l (95–286) vs. 75 pmol/l (45–143), 182 pmol/l (73–341) vs. 43 pmol/l (24–163)]. No differences were found for cTnI concentrations between both groups. Conclusions: The raised, but similar, cTnI values between hypothermia- and nonhypothermia-treated infants indicate similar myocardial damage in both groups. The lower BNP levels during hypothermia treatment suggest that hypothermia after perinatal asphyxia exerts a beneficial effect on cardiac function.

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Section: Discussionsupporting

confidence: 91%

“…Previous studies have shown elevated levels of cardiac troponin I (cTnI) in asphyxiated neonates. cTnI is thought to be an indicator of perinatal asphyxia-induced myocyte damage [6]. cTnI correlates strongly with the clinical grade of encephalopathy [7].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Biomarkers as Indicators of Hemodynamic Adaptation during Postasphyxial Hypothermia Treatment

Vijlbrief¹,

Benders²,

Kemperman

et al. 2012

Neonatology

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“…In this issue of Biology of the Neonate , Trevisanuto et al [3] have examined the value of troponin in asphyxiated neonates and have shown elevated values. What aspects of the molecular biology of troponin might produce pitfalls if it is measured in the neonatal population?…”

mentioning

confidence: 99%

Interpretation of Cardiac Troponin Measurements in Neonates – The Devil Is in the Details

Gaze

Collinson²

2006

Neonatology

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“…In their study, cord blood TnI level of critically ill infants like those who suffered acute respiratory distress, cardiac disorders, and pneumonia, was found higher than that of healthy infants [4]. Study by Trevisanuto et al (2006) also indicated the same thing, which showed significant differences between cord blood TnI level in the healthy and asphyxiated infants [24]- [26].…”

Section: Discussionmentioning

confidence: 89%

“…Heart muscle disorder in infants may be caused by asphyxia [7] [8] [18]- [21]. Cord blood Troponin I (TnI) is increased in infants with heart disorders [3] [7] [19] [22]- [26].…”

Section: Discussionmentioning

confidence: 99%

The Differences of Cord Blood Troponin I (TnI) Level between Normal and Asphyxiated Infants and Its Correlation with APGAR Score

Siddiq¹,

Krisnadi²,

Effendi³

2014

OJOG

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Asphyxia could increase infant morbidity and mortality. Ante-and intrapartum cardiotocography (CTG) examination could lead to a false positive diagnosis of asphyxia (fetal distress). Troponin I (TnI) is an important factor to the pathogenesis of asphyxia. Cord blood TnI level is increased in infants with fetal cardiac dysfunction, causing pathological CTG and low APGAR score (<7). In the future, TnI is expected to reduce false positive diagnosis of asphyxia caused by CTG. This research was conducted to examine and analyze the differences of cord blood TnI level between normal and asphyxiated infants and to determine the correlation between TnI level and APGAR score. An observational analytical cross sectional study was conducted to a total of 36 patients with asphyxiated infants (18 patients) and normal infants (18 patients). Subjects were selected according to the inclusion and exclusion criteria. Cardiotocography, TnI level, and APGAR score were examined. Umbilical cord blood samples were taken from each subject for the measurement of TnI level using a highly sensitive indirect sandwich Enzyme Linked Immunosorbent Assay (ELISA). Statistical analysis was performed by Mann-Whitney and Rank Spearman correlation coefficient test. Cord blood TnI level of asphyxia and normal groups were 1615.77 ± 1199.98 pg/mL and 819.88 ± 145.82 pg/mL respectively (p ≤ 0.05). Rank Spearman correlation coefficient between cord blood TnI level and 1' and 5' APGAR score was −0.523 (p = 0.026; p ≤ 0.05) and −0.502 respectively (p = 0.034; p ≤ 0.05). There was a statistically significant difference between cord blood TnI level of asphyxia and normal groups; cord blood TnI level of asphyxia group was higher than normal group. Furthermore, negative correlation was observed between cord blood TnI level and APGAR score. A. Siddiq et al.955

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Cardiac Troponin I in Asphyxiated Neonates

Cited by 48 publications

References 39 publications

Cardiac Biomarkers as Indicators of Hemodynamic Adaptation during Postasphyxial Hypothermia Treatment

Cardiac Biomarkers as Indicators of Hemodynamic Adaptation during Postasphyxial Hypothermia Treatment

Interpretation of Cardiac Troponin Measurements in Neonates – The Devil Is in the Details

The Differences of Cord Blood Troponin I (TnI) Level between Normal and Asphyxiated Infants and Its Correlation with APGAR Score

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