TWO-YEAR CATAMNESIS OF A CHILD WITH TRANSIENT MYOCARDIAL ISCHEMIA IN NEONATAL PERIOD

Purpose. To assess frequency and severity of myocardial damage in premature infants with transient myocardial ischemia in the early neonatal period.Materials and methods. The study includes 73 newborns of a gestational age of 31–36 weeks with respiratory failure and oxygen dependence in the first 2 hours of life. Newborns are divided into groups: Group 1: classic electrocardiographic criteria of transient myocardial ischemia and an increase in the level of troponin I in the blood; Group 2: electrocardiographic criteria for transient myocardial ischemia and a normal level of troponin I; Group 3: no ECG changes and normal troponin I level. We assessed blood gases, conducted electrocardiography, determined troponin I in the blood on the 1st and 7th day of life, assesses duration of oxygen therapy in all the children.Results. Group I: troponin I concentration on the 7th day of life – 0.415 [0.222; 0.639] ng/ml, Group II – 0.073 [0.051; 0.104] ng/ml and Group III – 0.017 [0.006; 0.051] ng/ml. Transient myocardial ischemia was detected in 41% of examined patients, and destructive myocardial changes – in 21.9%. An analysis of the gas composition of blood in the first 2 hours demonstrated that there was a significant predominance of the level of bases in the children of Group I. The duration of artificial ventilation in children of Group I was 56 [3; 96] hours, exceeding the indicators of children of Group II (9 [8; 11]) by 5 times, and Group III (20.5 [13; 72]) – by 2.5 times. Also newborns in Group I experienced a maximum need for oxygen therapy through a mask.Conclusion. 21.9% of premature infants experience destructive myocardial changes against the background of transient myocardial ischemia; newborns with transient myocardial ischemia and destructive changes have a significantly more pronounced metabolic acidosis in the first hours of life and a longer need for oxygen therapy.

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Activity of transient myocardial ischemia out of hospital in coronary artery disease and implications for management

The American Journal of Cardiology ◽

10.1016/0002-9149(85)90703-9 ◽

1985 ◽

Vol 56 (17) ◽

pp. I19-I22 ◽

Cited By ~ 1

Author(s):

Michael B. Rocco ◽

Stephen Campbell ◽

Joan Barry ◽

George Rebecca ◽

Elizabeth Nabel ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Myocardial Ischemia ◽

Transient Myocardial Ischemia ◽

Artery Disease

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Frequency and Outcomes of Transient Myocardial Ischemia in Critically Ill Adults Admitted for Noncardiac Conditions

American Journal of Critical Care ◽

10.4037/ajcc2003.12.6.508 ◽

2003 ◽

Vol 12 (6) ◽

pp. 508-517 ◽

Cited By ~ 27

Author(s):

Kathy J. Booker ◽

Karyn Holm ◽

Barbara J. Drew ◽

Dorothy M. Lanuza ◽

Frank D. Hicks ◽

...

Keyword(s):

At Risk ◽

Myocardial Ischemia ◽

Critically Ill ◽

Troponin I ◽

Advanced Age ◽

Elevated Troponin ◽

Cardiac Events ◽

Transient Myocardial Ischemia ◽

Critically Ill Adults ◽

Ill Adults

• Background Critically ill adults admitted for noncardiac conditions are at risk for acute myocardial ischemia.• Objectives To detect myocardial ischemia and injury in patients admitted for noncardiac conditions and to examine the relationship of myocardial ischemia, injury, and acuity to cardiac events.• Methods Transient myocardial ischemia, acuity, elevations in serum troponin I, and in-hospital cardiac events were examined in 76 consecutive patients. Transient myocardial ischemia, determined by using continuous electrocardiography, was defined as a 1-mm (0.1-mV) change in ST level from baseline to event in 1 or more leads lasting 1 or more minutes. Acuity was determined by scores on Acute Physiology and Chronic Health Evaluation II.• Results A total of 37 ischemic events were detected in 8 patients (10.5%); 32 (86%) were ST-segment depressions, and 35 (96%) were silent. Twelve patients (15.8%) had elevated levels of troponin I. Transient myocardial ischemia, elevated troponin I levels, and advanced age were significant predictors of cardiac complications (R2 = 0.387, F = 15.2, P < .001). Acuity correlated only modestly with increased length of stay in the intensive care unit (r = 0.26, P = .02) and elevated troponin I levels (r = 0.25, P = .03). Patients with transient myocardial ischemia had significantly higher rates of elevations in troponin I (P < .001) and cardiac events (P < .001) than did patients without.• Conclusions Transient myocardial ischemia and advanced age are predictors of cardiac events and may indicate patients at risk for cardiac events.

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