N-Terminal Pro-brain Natriuretic Peptide in Myocardial Injury AfterNeonatal Hypoxia-Ischemia

Abstract

Background:Neonatal asphyxia is a common pediatric disease. Asphyxia causes hypoxia and leads to
multiple organ damage of which heart damage is the most common. The aim of the present study was
to evaluate the changes of serum NT-proBNP levels after asphyxia-induced myocardial injury in
neonates. Patients and methods:A case-control study included forty neonates divided equally into:
case group with the diagnosis of perinatal hypoxia ischemia and control group admitted to
Neonatology Unit of Pediatric Department at zagazig University due to causes other than perinatal
hypoxia and cardiovascular problems.Serum troponin T and NT-pro BNP were measured in all
studied neonates. Results:Significant area under ROC curve was found with cutoff values >12.5
(ng/ml) and >22.5 (pg/ml) for troponin and BNP respectively. Sensitivity of 98% and 80% and
specificity of 97.0% and 78% respectively were reported for troponin and pro-BNP serum
levels.Conclusion:Our cases had myocardial damage evidenced by higher serum levels of troponin T
and pro-BNP compared with control group. Serum troponin T and pro-BNP were 98 and 80 sensitive
and 97 and 78 % specific for detection of myocardial injury in our patients. Cases with Hypoxic
ischemic encephalopathy (HIE) and those with multiple organ failure had a more pronounced
elevation of serum troponin T and pro-BNP compared with cases of hypoxia-ischemia with no HIE or
organ failure.