Retrospective diagnosis of hypoxic myocardial injury in premature newborns.
Perinatal asphyxia has a high impact on neonatal mortality, morbidity, and neurological outcome. The hypoxic effects on brain, kidney and gastrointestinal system are well recognized in newborns. While it is known that hypoxia also effects cardiac function, there are few studies of quantitative myocardial injury in premature infants who suffered hypoxia.


OBJECTIVE
To investigate usefulness of cardiac troponin (cTnT) and creatinine kinase MB (CK-MB) in the diagnosis of myocardial injury due to birth hypoxia and to correlate these markers with cardiac functions as measured by echocardiogram.


METHODS
We studied 43 preterm infants: 21 with birth asphyxia and 22 controls. Echocardiographic studies and quantitative determination of cTnT and CK-MB in blood serum was performed between the 12(th) and the 24(th) h of life.


RESULTS
cTnT and CK-MB levels were higher in asphyxiated infants compared to controls (0.287 +/- 0.190 vs. 0.112 +/- 0.099 ng/mL, P < 0.001) and (18.35 +/-14.81 vs. 11.09 +/- 5.17 ng/L, P < 0.05). Among controls, we observed an elevated value of cTnT in those with respiratory distress syndrome (RDS). We found a decrease in fractional shortening (P < 0.05) and an increase in tricuspid insufficiency (P < 0.01) in asphyxiated newborns.


CONCLUSIONS
cTnT and CK-MB levels are strong indicators of myocardial injury due to perinatal hypoxia. The cTnT level was most strongly related to RDS.
Szymankiewicz
Marta
M
Department of Neonatology, Poznan University of Medical Sciences, Poland. mszymank@gpsk.am.poznan.pl
Matuszczak-Wleklak
Marzena
M
Vidyasagar
Dharmapuri
D
Gadzinowski
Janusz
J
D001238:Asphyxia Neonatorum / Q000097:blood / Q000150:complications; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D052279:Creatine Kinase, MB Form / Q000097:blood*; D004562:Electrocardiography; D005865:Gestational Age; D006321:Heart / Q000503:physiopathology; D006801:Humans; D000860:Hypoxia / Q000097:blood / Q000150:complications*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis; D017202:Myocardial Ischemia; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood; D020107:Troponin T / Q000097:blood*
D015415:Biomarkers; D020107:Troponin T; D052279:Creatine Kinase, MB Form