Short-term prognostic value of serum cardiac troponin I levels in neonates with perinatal asphyxia

Gouda, Mohamed Hazem; Hammad, Bahaa S; Amen, Mohamed A

doi:10.4103/ajop.ajop_3_18

Cited by 3 publications

(2 citation statements)

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“…The cTnT level was significantly higher in neonates with echocardiographic signs of myocardial damage, while no differences were detected concerning functional items [18]. We found that a mild negative correlation existed between troponins and FS in all patients, while a significant negative correlation between serum cTnI and FS among asphyxiated neonates was previously described [19]. Some studies showed that cTnT levels correlated with echocardiographic findings of myocardial dysfunction, meaning it correlated positively with the left and right ventricle Tei index, stroke volume and left ventricular output, and negatively with mitral and tricuspid systolic velocity [19,20].…”

Section: Discussionsupporting

confidence: 66%

“…Nevertheless, in patients with severe PA, the cut-off value was 0.41 ng/mL for cTnT in the 3 rd day, with a specificity of 98% and sensitivity of 80%. It was found that the cut-off value for cTnT was 0.19 μg/L with a specificity of 100% and a sensitivity of 57% [19]. Slightly higher values of cardiac cTnI in the prediction of mortality after perinatal asphyxia with a cut-off at 0.135 μg/L (sensitivity 84.6%, specificity 85.9%) were described [24].…”

Section: Discussionmentioning

confidence: 99%

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Correlation between echocardiographic findings and biochemical markers in term newborns with moderate to severe perinatal asphyxia

Vasiljevic

Nešić

Krasić

et al. 2021

ARCH BIOL SCI BELGRA

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Perinatal asphyxia (PA) is a condition characterized by a gas exchange disorder due to a lack of blood flow or gas exchange, with potential multiorgan dysfunction. Our study aimed to determine the correlation between biochemical markers and echocardiography findings in a group of asphyxiated newborns. The prospective cohort study included 120 neonates (52/120 with PA) treated at a tertial referral pediatric center, from 2012 to 2014. A moderate-strong positive correlation was recorded between the transtricuspid pressure gradient (TRPG) and serum lactate, and between TRPG and NT-proBNP in the PA group (P<0.001) on the 1st day of life. A moderate positive correlation was found between NT-proBNP, lactate and troponins on one side, and TRPG on the other in the PA group after the 2nd measurement. Multinomial regression analysis showed that the lactate level was an independent factor for survival on the 1st (odds ratio (OR) 41.3, 95%confidence interval (CI) 2.14-797.1) and 3rd (OR 136.4, 95% CI 2.27-8206.7) days. Our research confirmed a significant correlation between echocardiographic and biochemical parameters of the myocardial lesion and cardiac function. Due to their complementarity, the use of the biochemical and echocardiographic parameters may be conditioned by their availability.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Correlation between echocardiographic findings and biochemical markers in term newborns with moderate to severe perinatal asphyxia

Vasiljevic

Nešić

Krasić

et al. 2021

ARCH BIOL SCI BELGRA

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Risk Factors for Clinical Seizures in Neonates with Hypoxic–ischemic Encephalopathy Treated with Therapeutic Hypothermia

et al. 2022

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Background This study aimed to assess the risk factors for clinical seizures in newborns treated with whole body cooling (WBC) for hypoxic ischemic encephalopathy (HIE). Methods Infants with gestational age≥36 weeks and birth weight≥2.000 g who were treated with WBC due to HIE were retrospectively enrolled in this study. Patients were assigned to two groups: infants without clinical seizures (Group 1) and infants with clinical seizures (Group 2). The two groups were compared to determine the risk factors for the occurrence of clinical seizures. Results A total of 25 patients (Group 1=10 and Group 2=15) were included in the study. Prothrombin time (PT) was determined as independent risk factor for clinical seizures (p=0.046) and the odds ratio for the effect of PT was found as 1.475 (%95 CI:1.006–2.299). PT (area under the curve [AUC]=0.764; p=0.041), and increased cardiac troponin-I (cTnI) (AUC=0.935; p=0.002) were found to be significant risk factors for predicting the occurrence of clinical seizures. The optimal PT cut-off value was 22.7 sec, with a sensitivity and specificity of 45.4% and 90%, respectively; as well as positive and negative predictive value of 83.3% and 60.0%, respectively. The chest compression in the delivery room, severely abnormal amplitude integrated electroencephalography and high encephalopathy score were also found risk factors for occurrence of clinical seizures. Conclusion Chest compression in the delivery room, high encephalopathy score, prolonged PT, and increased cTnI are significant factors for clinical seizures in newborns treated with WBC for HIE.

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Evaluation of Myocardial Injury Using Serum Cardiac Troponin-I in Asphyxiated Neonates at Enugu State University Teaching Hospital, Enugu, South-East Nigeria

Nwankwo,

Adiele,

Ekwochi

et al. 2024

Nigerian Journal of Clinical Practice

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Background: The burden of perinatal asphyxia remains high in our environment and when asphyxia is severe, vital organs are affected, with resultant multiorgan hypoxic-iscahemic injury to the heart, the brain, adrenals and other organs. Study Aim: To evaluate for myocardial injury in asphyxiated term neonates with hypoxic ischaemic encephalopathy using serum cardiac troponin-I (cTnI). Methods: The study was a hospital-based descriptive cross-sectional study involving sixty term asphyxiated neonates and sixty gestational age-and sex-matched controls. The subjects were term neonates with five-minute Apgar score ≤ 6 and HIE while the controls were healthy term neonates with five-minute Apgar score > 6. Five-minute Apgar score was utilized to classify asphyxia into mild, moderate and severe asphyxia. The degree of encephalopathy was determined by modified Sarnat and Sarnat criteria. The serum cTnI was measured in subjects and controls at 12-24 hours of life using Enzyme-linked immunosorbent assay technique. The serum bilirubin levels were also measured in participants to exclude hyperbilirubinemia. Results: The median serum cTnI levels was significantly higher in the subjects (0.56ng/mL; 0.25-0.94ng/mL) than in the controls (0.50ng/mL; 0.00-0.67ng/mL), respectively; p=0.001. Similarly, the median serum cTnI level in HIE stage II (0.56ng/mL; 0.38-0.72ng/mL) or III (0.56ng/ml; 0.50-0.94ng/mL) was also significantly higher than the median value in HIE stage I (0.38ng/mL;0.25-0.72ng/mL) or in controls (0.50ng/mL; 0.00-0.67ng/mL); p<0.001. There was significant positive correlation between serum cTnI levels and severity of HIE in asphyxiated neonates (rs = 0.505, p < 0.001). Conclusion: serum cTnI levels were elevated in severely asphyxiated neonates with HIE. The concentration of serum cTnI demonstrated significant positive correlation with HIE severity. Hence, the presence of HIE in asphyxiated neonates should prompt an evaluation for myocardial injury using serum cTnI. Any derangement noted should warrant instituting cardiovascular support in order to improve outcome and reduce asphyxia-related mortality.

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Short-term prognostic value of serum cardiac troponin I levels in neonates with perinatal asphyxia

Cited by 3 publications

References 0 publications

Correlation between echocardiographic findings and biochemical markers in term newborns with moderate to severe perinatal asphyxia

Correlation between echocardiographic findings and biochemical markers in term newborns with moderate to severe perinatal asphyxia

Risk Factors for Clinical Seizures in Neonates with Hypoxic–ischemic Encephalopathy Treated with Therapeutic Hypothermia

Evaluation of Myocardial Injury Using Serum Cardiac Troponin-I in Asphyxiated Neonates at Enugu State University Teaching Hospital, Enugu, South-East Nigeria

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