Aim: To measure serial cardiac troponin-T, creatine kinase, creatine kinase-MB, aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase levels in asphyxiated newborn infants during the first 15 d of life.
Methods: Troponin-T, creatine kinase, creatine kinase-MB, aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase (LDH) concentrations were measured prospectively in blood samples obtained from 45 asphyxiated and 15 healthy term neonates within the first 2-4 h, third, seventh and 15th days.
Results: Infants with severe asphyxia had significantly higher cardiac troponin-T levels than grade I and II asphyxiated and healthy neonates within the first 2-4 h of life (0.34+/-0.21 ag/ml vs 0.07+/-0.03 ag/ml, 0.12+/-0.07 ag/ml, 0.04+/-0.02 ag/ml, respectively). Troponin-T levels remained high on days 3 and 7 in severely asphyxiated neonates. The creatinine kinase-MB levels were significantly higher in grade II and III asphyxiated neonates than grade I asphyxiated and healthy neonates within the first 2-4 h. No difference was found in creatinine kinase-MB on day 3. There was cardiac involvement in 12 (80%) newborns of group III on B mode echocardiographic images on day 1. However, no echocardigraphic pathology was found in the seventh- and 15th-day echocardiographic analysis in any groups.
Conclusion: Our results suggest that asphyxia-related cardiac changes were significant but reversible in severely asphyxiated neonates, and troponin T is a good determinant of the degree of injury to the heart within the first week of life. Cardiac troponin T also has a wider diagnostic frame than other diagnostic markers of myocardial damage.