Document Type : original article
Authors
- Raheleh Faramarzi Garmroudi 1
- feisal rahimpour 2
- Maryam Aghdasi 3
- Reza Saeidi 4
- Maryam Emadzadeh 5
- Hassan Mottaghi Moghaddam shahri 6
- elahe Heidari 7
- Maryam Moradian 8
1 Assistant Professor of Neonatal-Perinatal Medicine Department of Pediatrics, School of Medicine Ghaem Hospital Mashhad University of Medical Sciences
2 Pediatric Cardiologist, Fellow in Interventional Electrophysiology, Rajaie Cardiovascular Medical & Research Center, Iran University of Medical Sciences, Tehran, Iran.
3 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5 Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
6 Associate professor of Pediatric Cardiology, Department of pediatrics, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
7 Department of pediatrics, Faculty of Medicine, Mashhad university of medical sciences, Mashhad, Iran
8 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Abstract
Background: Perinatal asphyxia may cause multiple organ dysfunctions, including myocardial dysfunction. This study aimed to evaluate the prevalence and features of myocardial dysfunction in perinatal asphyxia.
Materials and Methods: This study was carried out on 31 neonates (≥37 weeks) with perinatal asphyxia who were admitted to the Neonatal Intensive Care Unit (NICU). The neonates underwent electrocardiography (ECG) and echocardiography (ECHO) in the first 72 hours of birth. Moreover, in the first 24 hours of birth, 1 cc of blood was taken from the patients for cardiac troponin I (cTnI) and creatine kinase-myocardial band (CK-MB) testing. Following that, venous blood gas was recorded one hour later.
Results: The mean 1- and 5-min Apgar scores were 4±1.76 and 6.8±1.6, respectively. The mean value of serum cTnI was 4±1.76, and mean level of CK-MB was obtained at 136.51±258.51. ECGs were of grade 1. Mitral valve E-wave/Early diastolic (51%), followed by Tricuspid Regurgitation Vena Contracta (48.4%) was found to be the commonest ECHO abnormality, and Mitral annular plane systolic excursion (96.8%) was the most normal ECHO parameter. Infants with ECG grade 1 changes had a lower 5-min Apgar score (P=0.014), and higher serum cTnI level (P=0.002). No significant relationship of the ECG changes was found with the mean of Apgar at 1 min, umbilical vein PH, and CK-MB.
Conclusion: The ECG and ECHO changes, serum troponin I level, and 5-min Apgar score were found to be the predictors for myocardial dysfunction caused by asphyxia in newborn infants.
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