Global and and regional myocardial performance jn asphyxiated full-term infants assessed by doppler tissue imaging

الملخص EN

Background: perinatal asphyxia is a major problem influencing neonatal mortality and morbidity.

Cardiac troponin T (cTnT) is an established marker of post-hypoxic myocardial damage in neonates.

The value of Doppler Tissue Imaging (DTI) in assessing myocardial performance in these infants needs to be evaluated.

,,, Aims : To assess global and regional myocardial performance of full-term infants with perinatal asphyxia using DTI and to correlate them wjtb serum cTnT concentrations. Methods : in this prospective observational study, 25 asphyxiated and 20 non-asphyxiated term infants were investigated.

Serum cTnT concentrations were measured between 12 and 24 h of life.

Conventional 2-dimensional Doppler echocardiography and DTI were done during the first 72 h of life.

Results: Right ventricular (RV) and left ventricular (LV) Tei indices were significantly higher in asphyxiated neonates (mean + SD: 0.45 + 0.05 vs.

0.28 + 0.05, p<0.001 and 0.51 + 0.04 vs.

0.38 + 0.04, p<0.001, respectively).

Mitral and tricuspid systolic velocities were significantly lower in asphyxiated neonates (mean + SD: 5.06 + 0.89 vs.

6.89 + 0.94 cm / second, p<0.00frand 5.78 + 0.58 vs.

6.69 + 0.87 cm / second, p<0.001, respectively).

Serum cTnT concentrations were significantly higher in asphyxiated neonates [median (range): 0.17 (0.05-0.23) vs.

0.03 (0-0.07) ug / L, p<0.001)].

Serum cTrv Peorrelated positively witr rlVTei index (r = 0.67, p< 0.001); RV Tei index (r = 0.68, p<0.001) and negatively with mitral systolic (S) velocity (r = - 0.68; p<0.001) and tricuspid S velocity (r = - 0.41, p = 0.01).

LV end-diastolic and end-systolic dimensions were significantly larger in asphyxiated neonates.

No significant differences were found regarding other conventional echocardiographic measurements. Conclusion: Right ventricular and LV T indices were significantly higher in: asphyxiated neonates compared to control and they correlated positively with serum cTnT concentrations.

DTI allows for reliable information about regional and global systolic and diastolic performance even in the presence of normal ejection fraction.

Thus, DTI may be a useful addition in the echocardiographic workup and care of asphyxiated full-term Infants.