MiscellaneousFrequency of Elevations in Markers of Cardiomyocyte Damage in Otherwise Healthy Newborns
Section snippets
Methods
The institutional review board of the University of Rochester Medical Center approved this study. Parents gave written informed consent. We enrolled a convenience sample of healthy newborns at the University of Rochester Medical Center from 1999 to 2002. Umbilical cord and neonatal serum samples were obtained as close to 48 hours of age as possible and stored at −70°C. We abstracted perinatal data from maternal and neonatal medical records (Table 1, Table 2).
Stored sera samples were assayed at
Results
We enrolled 32 clinically healthy, full-term neonates whose sizes was mostly (91%) appropriate for gestational age and who had normal lengths of hospitalization (Table 1, Table 2). None had known or suspected cardiac disease, symptoms, or medications; maternal inflammatory events; severe congenital anomalies; reduced intravascular volume; renal dysfunction; postnatal infections; treatment with cardiotoxic medications; or glucocorticoid or thyroid supplementation. There was insufficient blood
Discussion
The proportion of neonates with elevated cTnT levels was higher than that in ill infants, children, and adolescents and in healthy adults in the published research,2, 9 suggesting that myocardial injury, although clinically occult, is common in this young age group. This conclusion is supported by elevations in the other markers of cardiomyocyte injury. It remains unclear whether these increased levels represent normal neonatal values associated with physiologic myocardial remodeling, occult
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Cited by (39)
Biomarkers of neonatal stress assessment: A prospective study
2019, Early Human DevelopmentCitation Excerpt :We provide our own reference values because the methods used in previous studies are not comparable with ours, with differences in terms of sampling site (peripheral- versus umbilical vein) and sampling time after birth. Indeed, serum troponin levels are higher in peripheral blood taken 48 h after birth than in umbilical cord blood [7] and Copeptin levels are higher in umbilical arterial- than venous blood [8]. CTnT and CTnI are the most specific and sensitive biochemical markers of myocardial cell damage.
Biomarkers in pediatric heart failure
2016, Progress in Pediatric CardiologyMolecular Pathology: Applications in Nonclinical Drug Development
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2015, Progress in Pediatric CardiologyCitation Excerpt :The increased levels of C-reactive protein in the blood of children with elevated cTnT concentrations support the contention of on-going cardiovascular alterations in these patients. We previously found that children with elevated serum CRP concentrations also have elevated cTnT concentrations [27–29]. This finding further confirms the fact that pathways of immune activation occur with doxorubicin-related cTnT elevations.
Fatal infant myocardial infarction caused by ball-in-valve mechanism from a dysplastic aortic valve
2013, Journal of Emergency MedicineCitation Excerpt :In one series of asymptomatic newborns, troponin was elevated in 16 of 17 neonates, with 2 of those elevated to levels representing MI (19). Nevertheless, troponins reportedly have been useful as biomarkers for myocardial injury in neonates and as an indicator of poor prognosis (19,20,22). Although these studies demonstrate that small elevations in troponin may be difficult to interpret in the setting of possible AMI, the utility of markedly elevated troponins for diagnosing AMI in infants has not been well studied.
Serial change in myocardial tissue doppler imaging from fetus to neonate
2013, Early Human Development