Cardiac troponin T and illness severity in the very-low-birth-weight infant
Danielle N Lopes1, José M Moraes Ramos, Maria Elizabeth Lopes Moreira
1Neonatal Intensive Care Unit, Clínica Perinatal Laranjeiras, 22240-002 Rio de Janeiro, Brazil.
Insights
Cardiac troponin T (cTnT) may indicate myocardial injury in very-low-birth-weight (VLBW) infants. Elevated cTnT levels were common in VLBW infants and linked to illness severity, suggesting its use as an early diagnostic marker.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
Background:
- Respiratory distress is common in very-low-birth-weight (VLBW) infants.
- Myocardial injury may influence disease outcomes in VLBW infants.
- Cardiac troponin T (cTnT) is a key marker for myocardial injury in adults but understudied in VLBW neonates.
Purpose of the Study:
- To investigate the role of cTnT in VLBW infants.
- To associate cTnT levels with clinical outcomes in this population.
Main Methods:
- VLBW infants admitted to the NICU were enrolled.
- Echocardiography and blood samples for cTnT were collected at 24 and 48 hours.
- cTnT values >0.1 ng/mL were defined as positive.
Main Results:
- 116 neonates had samples collected; median cTnT was 0.191 ng/mL at 24h and 0.293 ng/mL at 48h.
- Positive cTnT was associated with patent ductus arteriosus (PDA), low gestational age (GA), and dopamine use.
- Abnormal Doppler fluxometry and diuretic use showed protective effects.
Conclusions:
- A high prevalence of elevated cTnT was observed in VLBW infants, correlating with illness severity.
- cTnT may serve as a valuable early indicator of myocardial injury in VLBW neonates.
Abstract:
Introduction. Respiratory distress are very common in Very-low-birth-weight (VLBW) infants and Myocardial injury may play a role in the disease outcome. Cardiac troponin T (cTnT) is the most useful marker of injury in adult population, but has not been extensively studied in this population. Aim. To study the role of cTnT in VLBW infants and its association with clinical outcomes. Methods. All VLBW infants admitted to our NICU were included in the study. Echocardiography and blood samples for cTnT determination were collected at 24 and 48 hours of life, and values >0.1 ng/mL were considered CTnT-positive values. Results. A total of 116 neonates had their blood samples collected. The median cTnT concentration within 24 hours was 0.191 (0.1-0.79) ng/mL and within 48 hours was 0.293 (0.1-1.0) ng/mL. A logistic regression analysis showed that PDA, low GA, and use of dopamine were independently associated with positive cTnT and abnormal Dopplerfluxometry and diuretics use had protective effects and was independently associated with troponin values. Conclusion. We observed a high prevalence of positivecTnT values in VLBW infants associated with illness severity. Our findings suggest that cTnT may be a useful and early marker of myocardial injury in VLBW infants.
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