Biochemical markers of neonatal myocardial dysfunction

Area of Science:

• Neonatal cardiology
• Biochemistry
• Pediatric diagnostics

Background:

• Cardiac ultrasounds (US) are not always accessible at the bedside for neonates.
• Biochemical markers such as Cardiac Troponin I (cTnI), CK-MB, and NT-proBNP may serve as alternatives or complements for cardiac evaluation and treatment decisions.

Purpose of the Study:

• Establish reference ranges for cTnI, CK-MB, and NT-proBNP in healthy neonates.
• Investigate the dynamic changes of these markers in the early neonatal period.

Main Methods:

• Collected cord and neonatal blood samples for biochemical marker analysis.
• Performed blind cardiac ultrasounds for comparison.
• Measured cTnI, CK-MB, and NT-proBNP levels at various time points.

Main Results:

• CK-MB levels remained stable initially then decreased significantly.
• cTnI levels showed a rise within 72 hours, followed by a decline.
• NT-proBNP peaked at 24 hours and subsequently decreased over 10 days.

Conclusions:

• CK-MB is not recommended for neonatal myocardial damage assessment due to its muscle origin and relation to labor stress.
• Elevated cTnI may indicate physiological myocardial involvement in neonates.
• NT-proBNP changes reflect normal physiological ventricular adaptation to birth.