DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20174739

A study on cardiac troponin t in early diagnosis of myocardial injury due to perinatal asphyxia and its comparison with other modalities

N. Tamilarasu, K. S. Kumaravel

Abstract


Background: Perinatal Asphyxia is a multi-system disorder and its effects are not limited to central Nervous System. MODS determine the early outcome of asphyxiated neonate. Cardiac impairment occurs in about 25% of neonates with asphyxia. Often cardiac impairment is overlooked due to the lack of sensitive diagnostic test.

Methods: A hospital based prospective analytical study performed over 50 Asphyxiated neonates admitted in our NICU from September 2016 to January 2017 myocardial dysfunction was evaluated using clinical, electrocardiography, echocardiography and cardiac troponin-T card test.

Results: In the present study, among the 50 neonates 32 had clinical evidence of myocardial injury. Troponin T card test has the highest sensitivity of about 84.37%, positive predictive value of 93.1% and negative predictive value of 76% in diagnosing myocardial injury in contrast to ECG and ECHO. In terms of Specificity ECHO has the highest specificity of about 94.4% when compared to ECG and Trop T. Among all the diagnostic modalities used in this study, Troponin T best predicts the severity and outcome of Perinatal asphyxia.

Conclusions: Troponin T card test is a valuable tool for early detection of myocardial injury due to perinatal asphyxia. In resource limited setting where the accessibility to 12 lead ECG, ECHO, and aid of cardiologist are not available, Trop T card test will serve as an effective handy screening tool in diagnosing myocardial injury


Keywords


Cardiac troponin T, ECG, ECHO, Myocardial injury, Perinatal asphyxia

Full Text:

PDF

References


Caliskan E, Doger E, Cakiroglu Y, Duman C, TurkerG, Yucesoy I. Cord blood cardiac troponin I and creatine kinase MB levels in poor neonatal outcomes. J Turkish-German Gynecol Assoc. 2006;7:98-102.

Araujo K, Da Silva J, Sanudo A, Kopelman B. Plasma concentrations of cardiac troponin I in newborn infants. Clin Chem. 2004;50:1717-18.

Groenendaal F, Vries LS. Selection of babies for intervention after birth asphyxia. Semin Neonatol. 2000;5:17-32.

Baum H, Hinze A, Bartels P, Neumeier D. Reference values for cardiac troponins T and I in healthy neonates. Clin Biochem. 2004;37:1079-82.

Turker G, Babaoglu K, Gokalp AS, Sarper N, Zengin E, Arisoy AE. Cord blood cardiac troponin I as an early predictor of short-term outcome in perinatal hypoxia. Biol Neonate. 2004;86:131-7.

Trevisanuto D, Zaninotto M, Altinier S, Plebani M, Zanardo V. High serum cardiac troponin T concentrations in preterm infants with respiratory distress syndrome. Acta Paediatr. 2000;89:1134-6.

Vento M, Sastre J, Miguel AA, Jose V. American Thoracic Society: understanding cardiac troponin T in the newborn period. Am J Respir Crit Care Med. 2006;173:817.

Trevisanuto D, Picco G, Golin R, Doglioni N, Altinier S, Zaninotto M, et al. Cardiac troponin I in asphyxiated neonates. Biol Neonate. 2006;89:190-5.

Clark SJ, Newland P, Yoxall CW, Subhedar NV. Concentrations of cardiac troponin T in neonates with and without respiratory distress. Arch Dis Child. 2004;89:348-52.

Vento M, Sastre J, Asensi MA, ViƱa J. Room-air resuscitation causes less damage to heart and kidney than 100% oxygen. Am J Respir Crit Care Med. 2005;172:1393-8.

McAuliffe F, Mears K, Fleming S, Grimes H, Morrison JJ. Fetal cardiac troponin I in relation to intrapartum events and umbilical artery pH. Am J Perinatol. 2004;21:147-52.

Gaze DC, Collinson PO. Cardiac troponin I should be interpreted with caution in pediatric neonatal patients. Biol Neonate. 2004;87:19.

Clark SJ, Newland P, Yoxall CW, Subhedar NV. Cardiac troponin T in cord blood. Arch Dis Child. 2001;84:34-7.

Oyvind H, Kenneth D. Cardiac troponins I and T in patients with suspected acute coronary syndrome: a comparative study in a routine setting. Clin Chem. 1998;44:1430-6.

Gonzalez de Dios J. Definition of perinatal asphyxia in the medical literature: the need for a consensus. Rev Neurol. 2002;35:628-34.