The significance of second generation cardiac troponin I in early screening of hypoxic-ischemic encephalopathy after perinatal asphyxia

INTRODUCTION: In the last few years the use of cardiac troponin I and T, as diagnostic and prognostic factors of ischemic myocardial injury both in adult and neonatal medicine has been of great interest. OBJECTIVE: The objective of our research was to investigate the significance of cardiac troponin I (cTnl) as an early indicator of the presence and severity of hypoxic-ischemic encephalopathy (HIE) in newborns. METHODS: We analyzed 55 term newborns with HIE diagnosed based on clinical findings and ultrasonographic examination of the central nervous system. Serum concentration of cTnl-ultra was determined by immunoenzyme method during the first 24-48 hours after birth, and the obtained findings were compared with the values of identical parameter in 36 healthy term newborns. RESULTS: During the first 24-48 hrs after birth, serum concentration of cTnI-ultra was significantly higher (p < 0.0005) in term newborns with HIE (0.135 +/- 0.207 microg/l) and median (0.07, 0.01-006 microg/l) in comparison to control group (0.0183 +/- 0.026 microg/l and median 0.01 (0.01-0.01 microg/l), with the cTnl-ultra level rising proportionally to the clinical HIE stages. The increase of cTnI-ultra of > 0.12 microg/l indicated the development of significant cerebral damage with the sensitivity of 75% and specificity of 72.2%, while the cTnI-ultra level of > 0.13 microg/l was a significant mortality predictor with sensitivity of 76.9% and specificity of 73.8%. CONCLUSION: The second generation cardiac troponin I assay highly correlates with clinical and ultrasonographic findings in neonates with HIE, so that it can be used as a significant diagnostic and prognostic indicator of this pathological condition.