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

Introduction: Neonatal hypoxic ischemic encephalopathy is a major cause of chronic disability in childhood. Myocardial functions are affected by hypoxia. Signs of myocardial dysfunction depend on the severity of the injury. Objectives: the current study is designed to assess myocardial performance of full- term newborns with hypoxic- ischemic encephalopathy using echocardiography and cardiac troponin I and find out the relationship with HIE stages and also to analyze the association of the disease and its clinical stages with nitric oxide synthase(NOS) gene polymorphism. Material and methods: Thirty asphyxiated full-term newborns were consecutively enrolled in this study and another cross-matched twenty normal newborns as control group. All subjects were subjected to echocardiographic assessment of myocardial functions, measurement of serum cTnI and and DNA extraction from whole blood. Results: The systolic and diastolic functions were significantly impaired in the studied patients in comparison with controls(p<0.001). There was significant impairment in systolic functions in stage III HIE cases as regards FS%, EF%, TAPSE and MAPSE(p<0.001, p<0.001, p=0.007 and p=0.003 respectively). Also, there was significant impairment in diastolic function in stage III HIE cases as regard deceleration time(p=0.002)

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