Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Introduction: Myocardial functions are affected by the stress conditions such as shock and hypoxia. Signs of myocardial dysfunction depend on the severity of the injury. Hypoxia in the asphyxiated newborns often causes myocardial dysfunction. Objectives: The current study is designed to assess myocardial performance of full-term infants with perinatal asphyxia using tissue Doppler imaging (TDI) and to correlate it with serum cardiac troponin I( cTnI) concentrations. Material and methods: Twenty asphyxiated full-term newborn were consecutively enrolled in this study and another cross-matched twenty normal newborns as control group. All patients were subjected to measurement Serum cTnI concentrations that were measured between 12 and 24 hours of life. Conventional two-dimensional Doppler echocardiography and TDI were done during the {uFB01}rst 72 hours of life. Results: Cases with HIE had significant elevation of cTnI (p= 0.007), and serum troponin was significantly elevated among non-survivors newborns (p=0.008). Also lower pH and higher cTnI were significantly associated with higher risk of mortality among neonates with HIE (p=0.036 and p=0.038) respectively. There was significant difference between cases and controls as regards LV-DD in both pulsed wave and TDI (p<0.001); while the RV-DD showed no statistically difference between both groups .In our study, analysis of cutoff values, sensitivity, specificity, and area under ROC curves for dif»ferent markers of myocardial dysfunction revealed that serum cTnI, LV-E'/A', IVS-E'/A' and RV-E'/A' showed the highest diagnostic/prognostic values in predicting mortality in asphyxiated infants compared to other parameters (sensitivity 88.9%, 88.9%, 88.9%, 77.8% and specificity 72.7%, 45.5%, 63.6% and 54.5%respectively)

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