Correlation of cardiac troponin T levels with inotrope requirements,HIE stages and outcome in asphyxiated neonates

Abstract

Background

Asphyxial event can compromise the function of many vital organs like brain, heart, and kidneys. Cardiac dysfunction results from hypoxic injury to subendocardial tissue, papillary muscle, and myocardium. The aim of this work was to assess correlation between cardiac troponin T levels, myocardial dysfunction, inotrope requirements, hypoxic ischemic encephalopathy (HIE) stages, and outcome in asphyxiated neonates.

Methods

This cohort study was conducted on 48 neonates aged (1–28) days old, both sexes, exposed to perinatal asphyxia, and admitted in NICU unit in Benha University Hospital during the period from September 2022 to August 2023. Neonates had blood drawn for CBC, liver, kidney functions, and serum troponin T levels. Also, assessment by echocardiography and MRI were done to these patients in the first 3 days.

Results

Troponin T levels were significantly higher in neonates with myocardial dysfunction (systolic or diastolic), who required inotropic support, mechanical ventilation, or who were non-survivors. Troponin T levels significantly correlated with HIE severity, as assessed by Apgar scores and Sarnat staging. ROC curve revealed that cardiac troponin T levels have high accuracy at a cutoff value of >0.18 ng/mL, >0.18 ng/mL, and >0.18 ng/mL, respectively, in detecting myocardial dysfunction, morbidity, and mortality in patients with HIE with reliable sensitivity (84.2%–92.3%) and specificity (88.2%–93.1%).

Conclusions

Elevated cardiac troponin T is highly suggestive of myocardial dysfunction in cases of HIE. It is significantly correlated to severity of HIE, morbidity, and mortality in asphyxiated neonate.