Troponin T correlates with MRI results in neonatal encephalopathy.

Abstract

AIM:

Troponin is a sensitive marker of asphyxia in term infants mirroring the myocardial injury sustained in global hypoxia-ischaemia. In addition, troponin is a sensitive marker of severity of stroke in adults and neonatal encephalopathy (NE). We aimed to examine the relationship between troponin T in infants with perinatal asphyxia and brain injury on MRI and correlate with neurodevelopmental outcome.

METHODS:

Serum troponin was sampled in infants requiring resuscitation at birth and/or neonatal encephalopathy in a tertiary referral neonatal centre. Birth history, clinical parameters, neuroimaging and developmental outcome (Bayley Scores of Infant Development [BSID] III) were evaluated.

RESULTS:

Infants with perinatal asphyxia (n = 54) had serum troponin T measured and 27 required therapeutic hypothermia. Troponin T levels on days 1 and 2 were predictive of need for TH, development of seizures and grade II/III NE (AUC = 0.7; P-values < .001), troponin T levels on days 1, 2 and 3 were highly significant predictors of mortality (AUC = 0.99, P-values .005). The cut-off values of troponin T for best prediction of mortality were 0.84, 0.63 and 0.58 ng/mL on days 1, 2 and 3, respectively. Troponin T on day 3 of life was predictive of injury in the combined area of basal ganglia/watershed on MRI (AUC 0.70; P-value = .045).

CONCLUSION:

Infants with brain injury on neuroimaging following perinatal asphyxia had significantly elevated serum troponin, and troponin also correlated with developmental scores at 2 years. Further studies combining troponin and MRI may assist in the classification of neonatal brain injury to define aetiology, prognosis and response to treatment.

• Authors: Deirdre U Sweetman, Lynne Kelly, Tim Hurley, Chike Onwuneme, R William Gordon Watson, John F A Murphy, Marie Slevin, Veronica Donoghue, Eleanor J Molloy
• Journal: Acta paediatrica (Oslo, Norway : 1992) (Acta Paediatr) Vol. 109 Issue 11 Pg. 2266-2270 (11 2020) ISSN: 1651-2227 [Electronic] Norway
• PMID: 32281692 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Chemical References

• Troponin T

Topics

• Adult
• Asphyxia Neonatorum (complications, diagnostic imaging, therapy)
• Child
• Female
• Humans
• Hypothermia, Induced
• Hypoxia-Ischemia, Brain (diagnostic imaging, therapy)
• Infant
• Infant, Newborn
• Magnetic Resonance Imaging
• Pregnancy
• Troponin T