Cord Blood Cardiac Troponin I as an Early Predictor of Short-Term Outcome in Perinatal Hypoxia

Turker, Gülcan; Babaoğlu, Kadir; Gökalp, Ayşe Sevim; Sarper, Nazan; Zengin, Emine; Arısoy, Ayşe Engin

doi:10.1159/000079068

Cited by 52 publications

(73 citation statements)

References 26 publications

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“…5 The role of cardiac enzymes in the detection of ischemic damage to the heart is well established in adults. But recently, their role in the detection of ischemia in newborns due to perinatal birth asphyxia has been under debate.…”

Section: Discussionmentioning

confidence: 99%

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

Tamilarasu¹,

Kumaravel²

2017

Int J Contemp Pediatr

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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

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Section: Discussionmentioning

confidence: 99%

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

Tamilarasu¹,

Kumaravel²

2017

Int J Contemp Pediatr

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“…Konvülsiyonun olması HİE'nin orta veya ileri evrede olduğunu göstermektedir. Olguların çoğunda konvülsiyon ilk gün görülürken, ağır asfikside ise konvülsiyon genellikle doğumdan hemen sonra başlamaktadır (22). Asfiksi sonrası gelişen konvülsiyon; subtil (fragmanter), fokal klonik, multifokal klonik ya da tonik tarzda olmakta bunlar tek yada birlikte, bir kez ya da tekrarlayan şekilde görülebilmektedir (14).…”

Section: Discussionunclassified

“…Son yıllarda yenidoğan döneminde kardiyak troponinlerin, asfiktik bebeklerdeki miyokard hasarını yansıtabileceği tartışılırken, birçok merkez bu amaçla kardiyak troponin düzeylerini incelemektedir (7,8,22,24). Türker ve ark.…”

Section: Discussionunclassified

“…Türker ve ark. (22,25)'nın çalışmalarında 112 HİE bebekte Troponin I değerinin kontrol grubuna göre daha yüksek olduğu tespit edilmiş, ancak Troponin I değerinin doğum haftası, doğum ağırlığı, kan gazı ve Apgar skoruyla bir ilişkisi saptanmamıştır. Troponin I değerinin kesim noktası değerinin 0.35 ng/ml olduğu, bu değerin üzerindeki Troponin I değerlerinde mortalite ve ciddi ensefalopati geliştiği bildirilmiştir.…”

Section: Discussionunclassified

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The Evaluation Of The Association Of Laboratory Tests Associated With Mortality In Term Neonates With Hypoxic-ischemic Encephalopathy

Can¹,

Bülbül²,

Nuhoğlu³

2010

TUTFD

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ÖZETAmaç: Hipoksik iskemik ensefalopati (HİE) tanılı zamanında doğan yenidoğan bebeklerin erken dönem laboratuvar testlerinin mortalite ile ilişkisinin değerlendirilmesi. Gereç ve Yöntemler: Ocak 2004-Aralık 2008 tarihleri arasında HİE tanısı alan yenidoğan bebekler; yaşayan ve ölen olarak iki gruba ayırılarak prospektif olarak incelendi.Bulgular: Çalışmaya 32 yenidoğan alındı. Sarnat&Sarnat'a göre bebeklerin 9'u (%28.1) evre 1, 14'ü (%43.8) evre 2 ve 9'u (%28.1) evre 3 idi. Bebeklerin 8'i (%25) kaybedildi. Risk faktörlerinin korelasyon değerlendirme-sinde; antenatal takipsizlik (r²=0.35) ve konvülsiyon geçirmenin (r²=0.50) Sarnat evresi ile, Sarnat evresinin de mortalite ile pozitif ilişkili olduğu saptandı (r²=0.57). Laboratuvar testlerinde CK-MB ölüm oranı ile kuvvetli ilişkili (r²=0.74), troponin-I orta düzeyde ilişkili (r²=0.44), pH ise zayıf ilişkili bulundu (r²=0.27). Mortalite için CK-MB ve Troponin-I seviyelerinin prediktivitesinin yüksek, pH'nın ise orta dereceli olduğu saptandı. CK-MB'nin mortalite için duyarlılığı %100, özgüllüğü %91.6; Troponin-I'nın mortalite için duyarlılığı %100 ve özgüllüğü %70.8; pH'nın mortalite için duyarlılığı %75 ve özgüllüğü %87.5 bulundu.Sonuç: HİE tanılı zamanında doğmuş yenidoğan bebeklerde, erken dö-nem ölüm oranlarının, CK-MB değeri ile yüksek, Troponin-I değeri ile orta ve pH değeri ile zayıf ilişkili olduğu saptandı.Anahtar Sözcükler: Hipoksik-iskemik ensefalopati, mortalite, CK-MB, troponin-I, yenidoğan The evaluation of the relationships between the mortality and early period laboratory tests in the term infants diagnosed as hypoxic ischemic encephalopathy (HIE). Material and Methods:The newborns diagnosed as HIE between January 2004 and December 2008 were divided into two groups as the living and non-surviving groups. The two groups were evaluated prospectively.Results: Thirty two infants were included in the study. According to the Sarnat&Sarnat classification, 9 (28.1%), 14 (43.8%) and 9 infants (28.1%) were in stage 1, 2 and 3, respectively. Eight (25%) infants died. In the correlation evaluation of risk factors; lack of-follow-up at the antenatal period (r²=0.35) and having convulsions (r²=0.50) were positively associated with Sarnat stage. A positive relationship between Sarnat stage and the mortality rate was also determined (r²=0.57). CK-MB was strongly (r²=0.74), troponin-I moderately (r²=0.44), and pH weakly (r²=0.27) associated with mortality. In predicting mortality, the sensitivity and specificity for CK-MB was 100% and 91.6%, for Troponin I 100% and 70.8% and for pH 75% and 87.5%, respectively. Conclusion:This study demonstrates that in HIE, the relationship between the early period mortality rate and CK-MB values are strong, whereas for troponin-I and pH there is a moderate and weak association respectively.Key Words: Hypoxic-ischemic encephalopathy, mortality, CK-MB, troponin I, newborn : 28.01.2010: 28.01. Accepted: 07.05.2010 Giriş Hipoksik iskemik ensefalopati (HİE) intrapartum hipoksi veya geç antepartum serebral hipoksi ve iskeminin neden ol...

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“…Creatine kinase-MB and the cardiac troponins I and T (cTnI and cTnT) are the ones that are most in use. Creatine kinase-MB levels are elevated in newborns after perinatal and neonatal hypoxia-ischemia, but this elevation is not specific enough to be of clinical value (21,22). Troponin is an inhibitory protein complex located on the actin filament in all striated muscles, and consists of three subunits T, C, and I.…”

Section: Cardiac Troponinsmentioning

confidence: 99%

Use of cardiac biomarkers in neonatology

et al. 2012

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Cord Blood Cardiac Troponin I as an Early Predictor of Short-Term Outcome in Perinatal Hypoxia

Cited by 52 publications

References 26 publications

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

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

The Evaluation Of The Association Of Laboratory Tests Associated With Mortality In Term Neonates With Hypoxic-ischemic Encephalopathy

Use of cardiac biomarkers in neonatology

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