Utility of echocardiography and investigation of serum troponin T for detecting of hypoxic myocardial injury in newborns

Introduction: Perinatal hypoxia causes an important damage to the fetal myocardium with repercussions in both intrauterine and postnatal life, requiring a dia-gnosis and early therapy.

Objective: The purpose of the work:to present the main aspects of perinatal hypoxic myocardial injury and the utility of echocardiography(echo) and serum troponin T (cTnT) as a spe-cific marker for myocardial injury in perinatal asphyxia,for its diagnosis and follow up.

Methods: Patients: 82 newborns (0 – 14 days), normal birth weight, with peri-natal hypoxia (Apgar score 3 – 7), without major congenital heart diseases (CHD). All cases were investigated by clinical exam, ECG, chest X-ray, Doppler echocardiography performed at 2-7 day of life, the determination of serum troponin T(cTnT) at 22 patients All the cases received spironolactone 1-2mg/ kg/day for 3 months. Most of patients were evaluated clinically and echo after 6 months

Results: The patients had mainly signs of neurological post hypoxic suffering, cardiac exam: systolic murmur (6), signs of severe heart suffering (8 cases); Chest X-ray: cardiomegaly (39); ECG: LV repolarization distur-bances and low voltage of QRS (37), without ischemic changes; Echo: the absence of other CHD; myocardial LV hypertro-phy (42 cases), LV systolic dysfunction (5) and LV diastolic dysfunction (45). Reevaluation at 6 months: the reduction of the myocardial hypertrophy, normal LV systolic and diastolic function. Troponin T values were increased in 18/22 patients; cTnT valu-es: patients: 0.082 ± 0.166microg/l (normal values in health neonates 0.0186 ± 0.0286microg/l).

Conclusions: The perinatal hypoxia can induce an im-portant myocardial injury as hypoxic ischemic myo-cardopathy or transient post hypoxic hypertrophic car-diomyopathy at more than 62.2% of cases, the signs of CV suffering missing often. Echo is the main method for diagnosis and follow up of perinatal hypoxic cardi-omyopathy and is necessary performed from the first week of life. Troponin T values were increased in 20/22 newborns with perinatal hypoxia constituting a useful marker of hypoxic myocardial injury and requiring its current investigation

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)