Role of 2D echo in neonates with perinatal asphyxia and its correlation with cardiac troponin T levels and creatine kinase MB

To evaluate myocardial function in neonates with perinatal asphyxia by 2D Echo and cardiac Troponin T levels and creatine kinase MB.

30 term babies with perinatal asphyxia were selected as cases. They were evaluated within 48 hours of birth using clinical echocardiography and cardiac enzymes i.e. Troponin-T and CK-MB levels.

Incidence of cardiac dysfunction in neonates were reported and correlated with cardiac Troponin T levels and creatine phosphokinase MB-levels. In this study overall, 30% cases were reported with cardiogenic shock and cardiovascular dysfunction. 20% cases had clinical evidence of murmur. 16.6% cases had cardiac failure and 3.3% cases were asymptomatic. Cardiac enzymes were significantly increased in babies with perinatal asphyxia. Cardiac Troponin t levels ranges from 0.15->=0.3ng/ml. CPK-MB levels ranged from 200±110 IU/L in this study. Tricuspid regurgitation seen in 6.7% cases. RV hypokinesia (67% cases) >LV hypokinesia (33.3%) cases. Incidence of cardiac changes and mortality increases with increasing levels of Troponin T. Mortality was seen in 2 out of 30 cases. The mean Troponin-T level in cases with cardiac dysfunction was 0.3ng/ml as compared to without cardiac dysfunction (<=0.1ng/ml). Cardiac Troponin T had higher sensitivity and specificity compared to CK-MB levels. Cardiac Troponin-t levels correlated well with severity and outcome in babies with perinatal asphyxia.

Echocardiography and cardiac enzymes i.e. cardiac troponin T levels and CK-MB levels correlates well with severity and outcome in perinatal asphyxia.