الفهرس 
TroponinOnly 14 pages are availabe for public view
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Abstract
Introduction: Hemodynamic instability may harm the newborn heart. An electrochocardiogram can provide real-time information on the cardiovascular stability in conjunction with the clinical symptoms of the ill newborn. Cardiac troponin T (cTnT) is a specific and sensitive biomarker for myocardial affection in ill newborns who exhibit hemodynamic instability. Objectives: This controlled cross sectional study was carried out to evaluate level of cTnT levels in hemodynamically sick newborns and correlate it with echocardiography. Methods: Sixty neonates were included in the study and were subdivided into 2 groups; 30 healthy controls and 30 hemodynamic unstable ventilated and non-ventilated cases, admitted to the tertiary care NICU. Clinical examination, laboratory investigations, such as complete blood count (CBC), liver function tests, kidney function tests, bleeding profile, serum electrolytes, capillary blood gas, and C-reactive protein(CRP), cTnT level were measured within 48 hours of diagnosis of neonatal hemodynamic instability. Conventional M mode and tissue Doppler imaging (TDI) were recorded. Results: The studied cases had higher cTnT levels compared to controls [mean ± SD: 21.5 ± 13.1 vs. 116.3 ± 62.8 (p=0.000)]. Both ejection fraction% (EF) and fraction shortening(FS) were significantly decreased in cases as compared to controls (p<0.001), Mitral and tricuspid E/A ratios were significantly decreased in cases versus controls (p=0.041) (p=0.023) respectively, Tie index of left and right ventricles were significantly increased in cases versus controls (p=0.000) (p=0.002) respectively, Troponin T was significantly higher in hypotensive cases on inotropic support (p=0.001), there is a statistically negative significant connection between troponin T and EF (p=0.038), FS (p=0.025), mitral E/A ratio (p=0.000), there is a statistically positive significant connection between troponin T and tie index of left ventricle (LV) (p=0.017). Conclusions: increased cTnT in hemodynamically unstable neonates can be used as a marker for cardiac affection in sick babies. Hemodynamically unstable neonates revealed LV systolic and diastolic dysfunction when examined by echocardiography, demonstrating the ability of TDI-echocardiography to early detect cardiac dysfunction. Compared to neonates with stable hemodynamics, the myocardial performance index was higher in neonates with hemodynamic instability.