Himani Bhasin, Arvind Saili, Sushma Nangia

From Department of Neonatology, Kalawati Saran Children’s Hospital, New Delhi, India.

Abstract

Introduction: In perinatal asphyxia hypoxia is often responsible for myocardial ischaemia which may affect the neurodevelopmental outcome.

Objectives: To evaluate myocardial dysfunction in severe perinatal asphyxia by cardiac enzymes (CK Total, CK-MB, Troponin T), electrocardiography (ECG) and echocardiography and to find out its relationship with neurodevelopmental outcome.

Methods: Twenty five term neonates with severe perinatal asphyxia were enrolled and compared with 25 term babies without asphyxia. Myocardial involvement was assessed by ECG, echocardiography and CK total, CK MB and Troponin T measurements. Follow up at 3 months and 6 months was done for neurodevelopmental assessment using DASII.

Results: Twenty three (92%) cases had evidence of myocardial involvement as compared to one (4%) in control group. ECG was abnormal in 23 (92%) cases and 1 (4%) control. Serum levels of CK total, CK MB and Troponin T were raised in 23(92%), 23(92%) and 13(52%) cases respectively. Echocardiography was abnormal in 3 (12%) cases. ECG changes and enzymatic levels showed increasing abnormalities with severity of HIE in cases (p < 0.001). Cardiac enzymes, echocardiography (LVEF and RVEF) and ECG changes showed significant correlation with delayed neurodevelopmental outcome at 3 months and 6 months (p < 0.001).

Conclusion: Myocardial dysfunction may have an association with HIE severity and neurodevelopmental outcome.