ABSTRACT
This study was conducted on 43 neonates, and divided into 4 groups. Group I: comprised 14 age and sex matched apparently clinically normal neonates serving as a control group. Group II: included 13 patients with perinatal asphyxia. Group III: included 8 neonates with sepsis. Group IV: comprised 8 patients with clinical signs of congestive heart failure [CHF]. All the studied groups were subjected to: history taking, clinical examination, ECG, color Doppler echocardiography and estimation of plasma levels of cardiac troponin T [cTnT] using the high sensitive electrochemiluminescence immunoassay ECLIA as well as determination of plasma levels of total CK enzyme and CK-MB activity. Our results showed that the mean values of total CK mass and CK-MB activity were within the normal reference ranges for their gestational ages in all the studied groups. Both total CK mass and CK-MB activity showed no statistical difference in each group compared to the control group. The mean total CK mass and CK-MB activity did correlate with gestational age and birth weight in all cases. However significantly higher levels of cTnT were also evident in each individual patients group when compared to the control group The mean plasma level of cTnT didn't correlate significantly with gestational age, birth weight or mean level of total CK and CK-MB Echo findings in asphyxiated and sepsis groups were within normal range when compared to control group. The mean left ventricular end-diastolic dimension [LVDD] was significantly increased in group IV when compared to control group CTnT level didn't correlate with left ventricular ejection fraction [LVEF], fractional shortening [FS] in all studied groups but it correlated positively with LVDD in cases with CHF. We could conclude that in critically ill neonates higher cTnT concentration might indicate early myocardial injury. CTnT seems to be more useful to identify myocardial damage than CK and its isoenzyme CK-MB. The high analytical performance of the immunoassay we used electro-chemiluminescence technique [ECLIA] may allow detection of even minor myocardial cell damage missed by other cardiac enzymes or conventional cTnT assays