Tissue doppler and serum troponin for assessment of the effect of neonatal sepsis on left ventricular global and segmental functions in full term neonates / Rana Essam Mohamed Kassem ; Supervised Amr Mohamed Malash , Fatma Alzahraa Mostafa , Hanan Ali Madani

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Sepsis is one of the most common infectious conditions during the neonatal period, and it is still a significant cause of morbidity and mortality, despite the outstanding development of neonatology in recent years. Myocardial dysfunction is a well-described complication of severe sepsis, also referred to as septic cardiomyopathy, which includes both systolic and diastolic dysfunction. Many substances and mechanisms seem to be involved in myocardial dysfunction in sepsis, including toxins, cytokines, nitric oxide, complement activation, apoptosis and energy metabolic derangements.The aim of this study was to assess the left ventricle functions in full term neonates with sepsis and correlate these finding with the laboratory markers of neonatal sepsis. This study is a prospective case control study which was carried out at Neonatal Intensive Care Unit (NICU) of Children Hospital, Cairo University between January 2019 and april 2020 on 70 full term neonates divided into 2 groups: 35 with sepsis and 35 healthy age and sex matched controls.The full term neonates were subjected to full perinatal history : maternal illness, mode of delivery, sex, age, APGAR at 5 {u2013}minutes as well as meticulous clinical evaluation with emphasis on any sign of sepsis eg . feeding intolerance , temperature instability, apnea , poor reflexes, poor capillary refill>2 seconds. Investigations done were: CBC with differential , CRP , cardiac troponin-I , blood culture and echo (conventional and tissue Doppler imaging) for assessment of cardiac functions including diastolic functions and TEI index.The serum levels of CRP and cardiac Troponin-I were significantly higher in neonates with sepsis than in the controls.There was significant left ventricular dysfunction as evidenced by Tissue Doppler Imaging in the neonates with sepsis than in control group.Tei indices were significantly increased in neonates with sepsis than controls.There was significant positive correlation between Tei indices with CRP and troponin-I serum levels

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