Usefulness of cardiac troponin T and echocardiography in the diagnosis of hypoxic myocardial injury of full-term neonates.
BACKGROUND
Perinatal asphyxia constitutes a significant problem influencing neonatal mortality and morbidity.


OBJECTIVE
The aim of the present work was to provide evidence of the usefulness of cardiac troponin T (cTnT) and echocardiographic investigations in the diagnosis of heart damage in full-term infants after intrauterine hypoxia.


METHODS
The subjects were 39 asphyxiated and 44 term infants without fetal anoxia. Quantitative determinations of cTnT were performed between 12 and 24 h of life. Two-dimensional Doppler and color Doppler studies were performed at the bedside. We evaluated fractional shortening (FS), cardiac output (CO), cardiac index (CI), tricuspid (TI) and mitral (MI) insufficiency.


RESULTS
Asphyxiated infants presented increased cTnT (mean 0.141+/-0.226 vs. 0.087+/-0.111 ng/ml; p<0.01) and TI (38.5 vs. 11.4% of population; p<0.05) compared to healthy infants. CO, CI and FS remained in the same range.


CONCLUSIONS
We found cTnT to be the most useful among accessible diagnostic tools used in post-hypoxic heart damage in neonates. The data from our relatively small population study suggest a cTnT value of >0.1 ng/ml as a reliable marker of myocardial injury in neonates. Further study should be performed to generate a receiver-operator characteristic curve to discover what the cut-off level should be.
Szymankiewicz
Marta
M
Department of Neonatology, Poznan University of Medical Sciences, Poznan, Poland. mszymank@gpsk.am.poznan.pl
Matuszczak-Wleklak
Marzena
M
Hodgman
Joan E
JE
Gadzinowski
Janusz
J
D001238:Asphyxia Neonatorum / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002302:Cardiac Output / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D020107:Troponin T / Q000097:blood*
D020107:Troponin T