DIAGNOSTIC VALUE OF TROPONIN T LEVELS FOR DETERMINING CARDIAC DAMAGE
IN PERINATAL ASPHYXIATED NEWBORNS
Kılıç Z1, Sarhuş F1, Uçar B1, Tekin N1,
Çolak Ö2
University of
Osmangazi, Faculty of Medicine, Departments of Pediatrics1 and
Biochemistry2, Eskişehir, Turkey
Objective: The purpose of this study was to
investigate the diagnostic value of serum troponin T (TnT) levels in
determining cardiac damage due to perinatal asphyxia.
Methods: Thirty perinatal asphyxiated newborn infants of
32-40 weeks gestational age and a control group consisting of 30 healthy
newborns of 34-40 weeks gestational age were included in the study.
Umbilical arterial pH, blood gases, serum TnT and creatine kinase MB (CKMB)
levels in cord blood and the serum samples obtained at the 3rd,
6th, 12th, and 24th postnatal hours were
studied. Echocardiographic examination was done in the first day of life.
Results: Perinatal asphyxiated newborns had higher TnT
levels in cord blood (P<0.01) and in venous blood samples at all study
times (P<0.001) than control subjects. Also CKMB levels in cord blood
(P<0.01) and in venous blood samples (P<0.01 for 3rd hour,
P<0.05 for 6th, 12th, and 24th hours)
were higher in the study group than controls. Eleven cases (36%) who died
among asphyxiated newborns had higher TnT levels (P<0.05), lower
umbilical arterial pH value (P<0.05) and lower LVDD value (P<0.01)
than those who survived; however, there was no significant difference
between them for serum CKMB levels (P>0.05). The specificity rates for
TnT and CKMB were 100% and 96%, respectively for determining cardiac damage
in the perinatal asphyxiated newborns.
Conclusion: The measurement of cardiac specific TnT
levels is the diagnostic method of choice with the highest specifity rate
for determining cardiac damage during newborn period in perinatal asphyxia
cases in comparison to CKMB levels and echocardiographic measurements.