Troponin T correlates with MRI results in neonatal encephalopathy.

Autor: Sweetman DU; Department of Neonatology, National Maternity Hospital, Dublin, Ireland.; National Children's Research Centre, Dublin, Ireland.; Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland., Kelly L; Department of Paediatrics, Trinity College Dublin, Children's Health Ireland in Tallaght & Trinity Translational Medicine Institute, St James Hospital, Dublin, Ireland., Hurley T; Department of Paediatrics, Trinity College Dublin, Children's Health Ireland in Tallaght & Trinity Translational Medicine Institute, St James Hospital, Dublin, Ireland.; Coombe Women's and infant's University Hospital, Dublin, Ireland., Onwuneme C; Department of Neonatology, National Maternity Hospital, Dublin, Ireland.; UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland., Watson RWG; UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland., Murphy JFA; Department of Neonatology, National Maternity Hospital, Dublin, Ireland.; UCD School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland., Slevin M; Department of Neonatology, National Maternity Hospital, Dublin, Ireland., Donoghue V; Department of Neonatology, National Maternity Hospital, Dublin, Ireland., Molloy EJ; Department of Neonatology, National Maternity Hospital, Dublin, Ireland.; National Children's Research Centre, Dublin, Ireland.; Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland.; Department of Paediatrics, Trinity College Dublin, Children's Health Ireland in Tallaght & Trinity Translational Medicine Institute, St James Hospital, Dublin, Ireland.; Coombe Women's and infant's University Hospital, Dublin, Ireland.; Department of Neonatology, Children's Health Ireland in Crumlin, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2020 Nov; Vol. 109 (11), pp. 2266-2270. Date of Electronic Publication: 2020 Apr 13.
DOI: 10.1111/apa.15255
Abstrakt: Aim: Troponin is a sensitive marker of asphyxia in term infants mirroring the myocardial injury sustained in global hypoxia-ischaemia. In addition, troponin is a sensitive marker of severity of stroke in adults and neonatal encephalopathy (NE). We aimed to examine the relationship between troponin T in infants with perinatal asphyxia and brain injury on MRI and correlate with neurodevelopmental outcome.
Methods: Serum troponin was sampled in infants requiring resuscitation at birth and/or neonatal encephalopathy in a tertiary referral neonatal centre. Birth history, clinical parameters, neuroimaging and developmental outcome (Bayley Scores of Infant Development [BSID] III) were evaluated.
Results: Infants with perinatal asphyxia (n = 54) had serum troponin T measured and 27 required therapeutic hypothermia. Troponin T levels on days 1 and 2 were predictive of need for TH, development of seizures and grade II/III NE (AUC = 0.7; P-values < .001), troponin T levels on days 1, 2 and 3 were highly significant predictors of mortality (AUC = 0.99, P-values .005). The cut-off values of troponin T for best prediction of mortality were 0.84, 0.63 and 0.58 ng/mL on days 1, 2 and 3, respectively. Troponin T on day 3 of life was predictive of injury in the combined area of basal ganglia/watershed on MRI (AUC 0.70; P-value = .045).
Conclusion: Infants with brain injury on neuroimaging following perinatal asphyxia had significantly elevated serum troponin, and troponin also correlated with developmental scores at 2 years. Further studies combining troponin and MRI may assist in the classification of neonatal brain injury to define aetiology, prognosis and response to treatment.
(© 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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