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The assessment of time-dependent myocardial changes in infants with perinatal hypoxia
Ilker Cetin1, Aslı Kantar, Sevim Unal
1Ankara Child Health, Hematology, Oncology Education and Research Hospital, Ankara, Turkey.
Insights
Perinatal hypoxia causes myocardial damage in infants, with impaired cardiac function and elevated biomarkers persisting for at least one month post-birth. This study highlights the long-term cardiac effects of birth asphyxia.
Area of Science:
- Neonatal cardiology
- Pediatric critical care
- Cardiovascular physiology
Background:
- Perinatal hypoxia is a significant risk factor for neonatal morbidity and mortality.
- Myocardial damage following hypoxic-ischemic events can lead to long-term cardiovascular complications.
- Early detection and assessment of cardiac injury are crucial for timely intervention.
Purpose of the Study:
- To evaluate the extent and persistence of myocardial damage in infants experiencing perinatal hypoxia.
- To correlate cardiac biomarkers and echocardiographic findings with hypoxic injury.
- To assess the functional and structural cardiac changes in the first month of life.
Main Methods:
- Comparative analysis of 29 infants with perinatal hypoxia and 20 healthy controls.
- Biomarker assessment including cardiac troponin T (cTnT), creatine kinase-MB (CK-MB), and B-type natriuretic peptide (BNP).
- Echocardiography with tissue Doppler imaging to assess left ventricular (LV) function, myocardial velocities, and myocardial performance index (MPI).
Main Results:
- Elevated cTnT, CK-MB, and BNP levels were observed in hypoxic infants on day one.
- Reduced LV ejection fraction, fractional shortening, and myocardial velocities (systolic and diastolic) were noted at day one and one month.
- Increased LV MPI and prolonged isovolumic relaxation time indicated persistent diastolic dysfunction and impaired cardiac performance.
Conclusions:
- Infants with perinatal hypoxia exhibit significant myocardial damage.
- Cardiac dysfunction and elevated biomarkers persist for at least one month post-hypoxia.
- These findings underscore the need for ongoing cardiac monitoring in infants affected by perinatal hypoxia.
Objective:
The aim of the study was to assess myocardial damage in infants due to perinatal hypoxia.
Methods:
The findings of 29 infants with perinatal hypoxia and 20 healthy infants were compared. Blood gas analysis, serum lactate, cardiac troponin I (cTnI), troponin T (cTnT), creatine kinase-MB (CK-MB) and B-type natriuretic peptide (BNP) were evaluated. Echocardiography together with tissue Doppler imaging was performed.
Results:
cTnT, CK-MB and BNP were higher in patients at the first day. There were positive correlations between the left ventricular (LV) myocardial performance index (MPI) and cTnT at first day and also at first month. LV ejection fraction and fractional shortening were lower at first day and at first month in patients. Myocardial systolic (Sm) and diastolic (Em and Am) velocities at all segments were lower at first day, and interventricular septum Sm, LV Sm, LV Em, right ventricular Em and LV Am were still lower at first month in patients. Isovolumic relaxation time at all segments together with LV MPI was higher at first day, ejection time values were lower and MPI values were higher at all segments at first month in patients.
Conclusions:
These findings demonstrated that the signs of myocardial damage due to perinatal hypoxia still present at first month.
