Correlation of cardiac troponin T level, clinical parameters and myocardial ischaemia in perinatal asphyxia

Abstract

Introduction: Resource limitation in developing countries may preclude access to cardiac troponin-T assay thereby necessitating reliance on clinical judgment for identification of hypoxic myocardial cellular injury.
Objectives: To relate selected clinical signs with elevated serum cardiac
troponin-T in asphyxiated term neonates.
Methods: Asphyxia was identified by low umbilical arterial blood pH . 7.20 and low five minute Apgar score . 6 while controls were term, non.asphyxiated neonates. All babies were examined for heart rate,
heart rhythm irregularities, peripheral pulse volume, respiratory rate,
pallor, cyanosis, heart murmur and sensorium.
Results: Thirty term, asphyxiated neonates and their matched controls
were studied. Central cyanosis, reduced pulse volume, pallor, depressed
sensorium; tachycardia and tachypnea were all associated with increased odds ratios for abnormal cardiac troponin.T levels.
Conclusion: Clinicians working in resource.limited health facilities
should have a high index of suspicion for myocardial cellular injury
when these signs are elicited.

Keywords: neonates, asphyxia, troponin-T, myocardial injury