Abstract
Backgrounds: Perinatal asphyxia is frequently associated with heart impairment. In this study we related troponin serum levels (a cardiac ischaemic index in adults) with left ventricle B-mode functional evaluation in preterm infants with RDS
Methods: We studied 40 hypoxaemic preterm newborns affected by RDS, with gestational age ranging 26–34 w. and weight ranging 890-2400 gr. In all newborns pH, PaCO2, PaO2, HCO3, ABE, SBE, Heart rate, MAP, SaO2 and thoracic radiography, were evaluated at admission to the NICU of University of Catania. Infants were divided in 2 groups: The first with mean pH 7,17 +- 0,05 and serious RDS needing IPPV (16 patients); the second with mean pH 7,27 +- 0,03 and mild RDS not requiring IPPV (24 patients). Troponin determination was made 12 h after birth together with left ventricle echocardiography evaluation. End diastolic volume, End sistolic volume, Stroke volume (SV), cardiac output (CO) and Ejection Franction (EF) were studied by using B-mode ellipsoidal method.
Results: Mean serum levels of Troponin were significantly higher in the first group with severe RDS (0,26 +- 0,161 mcg/ml) than in the second with mild RDS (0,037 +- 0,0031 mcg/ml). We demonstrated a significant inverse correlation between Troponin levels and left ventricular functional index that were lower in the first group (SV 0,49+- 12 ml/b; CO 52,5 +- 14 ml/min; EF 46 +- 10%) than in the second (SV 1,14 +- 32 ml/b; CO 131,5 +- 34 ml/min; EF 59,2 +- 8%). It had been necessary adding inotropic therapy with Dopamine and Dobutamine in 12 patients of the first group.
Conclusions: These results suggest that elevated Troponin levels in preterm newborns are related both with hypoxic insult and with cardiac dysfunction. Troponin levels such as echocardiographic b-mode left ventricular evaluation can be helpful to objectively check myocardial function in preterm infants with RDS in order to early recognise heart impairment evaluating the correct use of inotropic therapy.
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Mattia, C., Sciacca, P., Betta, P. et al. 336 Troponin Serum Levels and Echocardiographic Left Ventricular Evaluation in Preterm Newborns with Respiratory Distress Syndrome. Pediatr Res 58, 412 (2005). https://doi.org/10.1203/00006450-200508000-00365
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DOI: https://doi.org/10.1203/00006450-200508000-00365