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Do serum troponin I concentrations correlate with severity of HIE?

Presented at the Neonatal Society 2010 Summer Meeting (programme).

Shastri AT, Samarasekara S, Clarke P

Neonatal Intensive Care Unit, Norfolk & Norwich University Hospital, UK

Background: Myocardial dysfunction occurs frequently in babies with perinatal asphyxia. Cardiac troponin I (cTnI) is a surrogate marker of myocardial dysfunction in adults but there are few data in neonates (1,2). We aimed to compare serum cTnI concentrations with clinical severity of encephalopathy in asphyxiated neonates.

Methods: Retrospective review of cTnI concentrations in neonates admitted to our neonatal unit with hypoxic ischaemic encephalopathy (HIE) in the 63-month period January 2005 to March 2010. We compared serum cTnI concentrations measured in the first 48 hours postnatal with clinical grade of HIE (Sarnat-Sarnat classification), and also with duration of inotropic support. Ethics approval was not required for this study.

Results: 42 neonates were admitted with HIE in the study period. Median (range) gestational age and birth weight were 38.8 weeks (27 – 42 weeks) and 3012 g (1080-4620 g). The table shows their cTnI concentrations and duration of inotropic support according to HIE grade:

 Data are median (range)

Conclusion: Cardiac troponin I concentrations correlate strongly with clinical grade of HIE and with duration of inotropic support in asphyxiated neonates. These data suggest that early cTnI concentrations provide a useful marker of the severity of myocardial dysfunction in asphyxiated neonates.

1. Türker G, et al. Biol Neonate 2004; 86:131-137.
2. Trevisanuto D, et al. Biol Neonate 2006; 89:190-193.

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