Hanan Mostafa Abo Raya1, Howyda Hosney El Gebaly1, Mohamed Amin Mekawy2, Maha Hassan Mohamed2
(1)Faculty of Postgraduate Childhood Studies – Ain Shams University, (2)Faculty of Medicine - Ain Shams University
Background: PDA is the most common cardiovascular abnormality in preterm neonates. Left to right shunting across the PDA is associated with congestive heart failure and increased ventilatory dependence. Echocardiography remain the gold standard for diagnosing PDA. cTnT is a marker of cardiac injury.
Aim:        to assess the rule of cTnT as a marker of cardiac injury in VLBW infants with clinically significant PDA and its relation to echocardiographic findings and clinical outcome.
Subjects and methods: Seventy-seven preterm infants born ≤ 1.5kg, were included, divided according to their diameter of PDA and whether having clinically significant PDA or not significant, into patients and control groups. For all neonates, echocardiography, CBC, CRP and cTnT measurement were done at 48 hours of life and as follow up 5-7 days later.
Results: Fourty-one preterm infants with a mean gestational age of 31.7±1.57 weeks and birth weight of (1.38±0.2kg) were included as patients group, 36 preterm infants were included as control group with a mean gestational age of 32.2±0.9 weeks and birth weight of (1.63±0.2kg). On the second day, infants of the patient group had significantly higher mean cTnT levels (0.31±0.06 ng/dl) than those in control group (0.16±0.03 ng/dl).
There were statistically significant decrease in LVESD in patients than in control group initially (9.00±1.94, 14.72±1.56, p=0.023).
There was statistically significant increase in the number of the patients having right ventricular hypertrophy (p=0.001), mild mitral regurgitation (p=0.005), pulmonary stenosis (p=0.03) and highly significant trivial tricuspid regurgitation (p=0.000), and greater diameter of PDA (p=0.000) in patient group than in control group in the first 48 hours.
Conclusion: cTnT in conjunction with echocardiography may provide the basis for early diagnosis and detection of complication of VLBW infants with hemodynamically significant PDA for trials of targeted medical treatment.
Keywords: cTnT: cardiac troponin, PDA: Patent ductus arteiosus, LVESD: left ventricular end systolic diameter, VLBW: very low birth weight