Screening for myocardial dysfunction among asphyxiated newborns using echocardiography

BACKGROUND:

PERINATAL /BIRTH / NEONATAL ASPHYXIA is a medical condition caused by the interruption of oxygen supply in newborn infant which can last long during birth process  and can lead to physical harm , mainly to brain and finally leads to metabolic acidosis , neonatal encephalopathy , multi - organ dysfunction. Incidence of this condition varies from 0.5 – 2% of live births.

Cardiovascular changes include; myocardial ischemia, poor contractility, cardiac stunning, tricuspid insufficiency and hypotension. Myocardial dysfunction results in decreased blood supply to various other organs leading to irreversible damage and increases mortality.

The diagnosis of myocardial injury in neonates with birth asphyxia is based on clinical evaluation, electrocardiographic and echocardiographic findings and serum Troponin T enzyme concentrations.

Aim:  To assess the myocardial function by Tissue Doppler Imaging  and by comparing with Troponin T level, since the data available is limited in our population.

METHODS:

This is a Prospective Case – Control study which includes 30 cases and 30 controls. Neonates with asphyxia who are admitted in NICU will be included in the study.

CONCLUSION:

• Asphyxiated neonates showed significant reduction in biventricular performance in comparison with healthy neonates, however serial assessment reveled improvement in hemodynamics at 48 hours in response to standard medical therapy
• Neonates with asphyxia were mostly preterm and had lesser cardiac dysfunction
• Tissue Doppler Imaging showed significant decrease in septal tissue annular velocity among asphyxiated neonates which remain unaltered when assessed at 48hours.

1.      Sara Varghese - SOAHS , MAHE, Manipal

2.      Krishnananda Nayak, Associate Professor and Head, Department of CVT, SOAHS, MAHE, Manipal

3.      Tom Devasia- Prof. and Head, Department of Cardiology , KMC, MAHE,  Manipal

4.       Leslie Edward Lewis-  Professor, Dept. of Pediatrics, KMC, MAHE,  Manipal    

5.      Sridevi Prabhu- Asst.Prof. of Dept. CVT , MAHE,  SOAHS, Manipal 

6.      Sulochana Badagabettu, Associate Professor, MCON, MAHE, Manipal