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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. Objectives: 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. Material and 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 ± 0.111ng/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.