scholarly journals Diagnostics of myocardial damage in premature newborns with transient heart disease in the early neonatal period

2019 ◽  
Vol 64 (5) ◽  
pp. 38-43
Author(s):  
O. A. Vazemiller ◽  
A. A. Vaganov ◽  
N. K. Golubenko ◽  
R. Kh. Aksanova ◽  
A. B. Salmina ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
Premature Infants ◽  
Oxygen Therapy ◽  
Troponin I ◽  
Neonatal Period ◽  
Myocardial Damage ◽  
Group Iii ◽  
Early Neonatal Period ◽  
Group I ◽  
Transient Myocardial Ischemia

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.

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

2003 ◽  
Vol 12 (6) ◽  
pp. 508-517 ◽  
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.

Clinical evaluation of immunochemical assay of lactate dehydrogenase isoenzyme 1 in early detection of acute myocardial infarction.

1982 ◽  
Vol 28 (10) ◽  
pp. 2152-2154 ◽  
Author(s):  
T Y Wang ◽  
J H Godfrey ◽  
L G Graham ◽  
M N Haddad ◽  
T C Hamilton
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Lactate Dehydrogenase ◽  
Myocardial Ischemia ◽  
Clinical Presentation ◽  
Myocardial Infarct ◽  
Acute Myocardial Infarct ◽  
Group Iii ◽  
Dehydrogenase Isoenzyme ◽  
Group I

Abstract We immunochemically measured lactate dehydrogenase isoenzyme 1 (LD-1), calculated LD-1/LD ratios (% LD-1) for 122 specimens from 60 patients, and compared the results with those for the conventional cardiac profile and other findings such as clinical presentation and electrocardiogram. Results for LD-1 and % LD-1 could be classified into three groups: group I, with LD-1 less than 64 U/L; group II, with LD-1 greater than 64 U/L and % LD-1 between 17 and 37%; and group III, with LD-1 greater than 64 U/L and 5 LD-1 greater than 38%. These three groups correlated closely and consistently with three patients of cardiac profile, i.e., those of no acute myocardial infarct, myocardial ischemia, and acute myocardial infarct, respectively.

scholarly journals The effect of chronic infection foci in the mother on the development of acute kidney injury in premature infants with hemodynamically significant patent ductus arteriosus

2020 ◽  
pp. 13-18
Author(s):  
T.P. Borysova ◽  
◽  
O.U. Obolonska ◽  
◽  
Keyword(s):  
Acute Kidney Injury ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Kidney Injury ◽  
Maternal Infection ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Patent Ductus

Nephrogenesis may be disrupted antenatally because of chronic infection foci (CIF) in the mother, the development of chorioamnionitis, feto-placental insufficiency. As a result, in the postnatal period, the kidneys are more sensitive to hypoperfusion, which occurs in premature infants with hemodynamically significant patent ductus arteriosus (HSPDA) and can lead to the development of acute kidney injury (AKI). Purpose — to study the influence of CIF in the mother on the development of AKI in premature infants with HSPDA. Materials and methods. 74 premature infants (gestational age 29–36 weeks) who were treated in the Department of Anesthesiology and Neonatal Intensive Care MI «Dnepropetrovsk Regional Children's Clinical Hospital» Dnepropetrovsk Regional Council» were examined. Patients were divided into three groups depending on the presence of a patent ductus arteriosus (PDA) and its hemodynamic significance: Group I — 40 children with HSPDA, Group II — 17 children with PDA without hemodynamic disorders, Group III — 17 children with a closed ductus arteriosus. The presence of CIF in the mother was determined according to medical records, chorioamnionitis on the basis of histopathological examination of the placenta. Patients with HSPDA were divided into two subgroups: 28 children from mothers with CIF, 12 — without CIF. Clinical examination and treatment of premature infants was carried out according to generally accepted methods. Echocardiography with Doppler was performed at 5–11 hours of life and then daily to determine PDA, its size and hemodynamic significance. Diagnosis and stratification of the severity of AKI were performed according to the criteria of neonatal modification of KDIGO, for which the concentration of serum creatinine and diuresis were studied. Results. Chronic foci of infection were found in 28 (70.0%) mothers of group I, in 5 (29.4%) — group II, in 6 (35.2%) — group III. Chorioamnionitis in group I — 10 (25%) cases, in group II–ІII — 6 (17.6%). The presence of CIF in the mother caused a significant increase in the size of the PDA on the first day of life in the group of HSPDA against groups II–III: 2.61±0.861 (2.3; 2–3.5) mm against 1.79±0.365 (1.7; 1.5–2) mm, p<0.001. Patent arterial duct with a diameter of >2 mm on the first day of life in premature infants of group I from mothers with foci of infection was observed more often — 19 (67.9%) against 2(6.7%) of groups II–III (OR=10.56; CI: 1.9–58.53, p<0.005). Analysis of the incidence of AKI on the third day of life depending on HSPDA and the presence of CIF showed that 64.3% of preterm infants with HSPDA and maternal infection developed AKI — 6.6 times more often than in groups without HSPDA (OR=8.40; CI: 2.60–27.14; p<0.001), and 2.6 times more often compared to children of the subgroup HSPDA without recorded maternal infection (OR=5.40; CI: 1.18–24.65; p<0.03). On the background of HSPDA and CIF stage II–III AKI was observed in every third child. Comparative analysis within group I depending on the CIF revealed that the frequency of AKI for 10 days in the subgroup with infection was almost three times higher than the level of the subgroup without infection: 71.4% vs. 25.0% (OR=7.50; CI: 1.60–35.07; p<0.009). Conclusions. The presence of CIF in the mother is a risk factor for AKI in premature infants with HSPDA. Therefore, such children should be classified as at risk of developing AKI. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: acute kidney injury, chronic foci of maternal infection, hemodynamically significant patent ductus arteriosus, premature infants.

scholarly journals Role of Carvedilol in Prevention of Adrenaline Induced Myocardial Infraction in Experimental Animal

2016 ◽  
Vol 12 (2) ◽  
pp. 127-134
Author(s):  
Wahida Rahman ◽  
Nargis Akhter ◽  
Md Abrar Hossain ◽  
Sayeda Nazrina
Keyword(s):  
Free Radical ◽  
Reduced Glutathione ◽  
Myocardial Necrosis ◽  
Myocardial Damage ◽  
Antioxidant Property ◽  
Free Radical Production ◽  
Group Iii ◽  
Radical Production ◽  
Group I

Introduction: Acute myocardial infarction (AMI) is the most important form of ischemic heart disease (IHD). Coronary artery disease (CAD) is an increasingly important medical and public health problem and is the leading cause of mortality in Bangladesh. AMI is the rapid development of myocardial necrosis caused by a critical imbalance between the oxygen supply and demand of the myocardium. Total occlusion of the coronary arteries for more than 4-6 hrs results in irreversible myocardial necrosis, but reperfusion within this period can salvage the myocardium and reduce morbidity and mortality. Objectives: To assess the role of carvedilol in prevention of adrenaline induced cardiac damage in experimental animal. Materials and Methods: This experimental study was carried out in the department of pharmacology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka for a period of One year spanning from July 2004 to June 2005. Fifty two healthy rats of Long Evan Norwegian strains, 3-4 months of ages of both sexes, weight between 180-220g were used. The experiment was divided into two parts: Part-I and Part-II. Thirty two rats were selected for Part-I experiment and subdivided into Group-I and Group-II. In Part-II experiment, 20 rats were selected and placed as Group-III. Group-I (12 rats) of control group was treated with 02 doses of inj distilled water (D/W) subcutaneously (S.C.) 24 hrs apart and serum creatine kinase-MB (CK-MB) level and hepatic and cardiac reduced glutathione (GSH) contents were estimated from 06 (Group-Ia) rats after 12 hrs and serum aspartate aminotransferase (AST) level and hepatic and cardiac reduced GSH contents were estimated from 06 (Group-Ib) rats after 24 hrs of 2nd inj of D/W. Group-II (20 rats) was treated with 02 doses of inj adrenaline (2mg/kg) S.C. in 24 hrs interval and in above mentioned way serum CK-MB level, GSH (hepatic and cardiac) contents and serum AST and GSH (hepatic and cardiac) contents were estimated 12 hrs and 24 hrs after the 2nd inj of adrenaline respectively. In experimental group (Group-III) all the rats (20) were treated with carvedilol (1 mg/kg) orally for 14 consecutive days and then were given 02 doses of inj adrenaline with the interval of 24 hrs and again serum CK-MB level and GSH (hepatic and cardiac) contents were estimated from half of the rats (10) after 12 hrs of injection and serum AST level and GSH (hepatic and cardiac) contents were measured from half of the rats (10) after 24 hrs of 2nd injection of adrenaline. Results: Adrenaline (2mg/kg) induced myocardial damage was evaluated biochemically by significant (P˂0.001) increase in CK-MB and AST levels. Free radical production following adrenaline induced myocardial damage was reflected by significant (P˂0.001) depletion in hepatic and cardiac reduced glutathione (GSH) contents. Cardioprotection provided by carvedilol pretreatment in adrenaline induced myocardial infarction was assessed by significant prevention of increase in serum CK-MB and AST levels. Antioxidant property of carvedilol was evaluated by significant (P<0.001) prevention of depletion in hepatic and cardiac GSH contents. The results of the study indicated that carvedilol pretreatment provided effective prevention in adrenaline induced myocardial damage and also provided effective antioxidative action. Conclusion: This study indicated that adrenaline administration induced myocardial damage as evidenced by increase in serum CK-MB and AST levels which was associated with free radical production as reflected by depletion in hepatic and cardiac GSH contents. It was observed that carvedilol through their antioxidant property in addition to their β-blocking effect prevents free radical mediated injury of catecholamine assault following MI. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 127-134

scholarly journals Cardiac troponin as biochemical marker of perinatal asphyxia and hypoxic myocardial injury

2009 ◽  
Vol 66 (11) ◽  
pp. 881-886
Author(s):  
Aleksandra Simovic ◽  
Jasmina Knezevic ◽  
Zoran Igrutinovic ◽  
Nadezda Stojanovic ◽  
Sanja Kocic
Keyword(s):  
Cardiac Troponin ◽  
Pressure Support ◽  
Troponin I ◽  
Perinatal Asphyxia ◽  
Myocardial Cell ◽  
Group Iii ◽  
Average Value ◽  
Group I ◽  
Group Ii ◽  
Future Outcomes

Background/Aim. Myocardial cell lesion in newborns may be clinically occult. In recent years there has been shown growing interest in the use of cardiac troponin-I (cTnI) in relation to perinatal asphyxia and hypoxic myocardial lesion. The aim of this study was to determine a relationship between high cTnI levels and outcome in critically ill newborns with perinatal asphyxia. Methods. In this study 78 patients were divided into three groups. The group I included 39 newborns (15 term and 24 preterm) with perinatal asphyxia, with no deaths, only full or partial (with some neurological sequels) recovery. The group II included 10 newborns (6 preterm and 4 term), with perinatal asphyxia who died, with critical cardio-respiratory problems and multiorgan dysfunction. The group III included 29 healthy term newborns. A level of cTnI in all three groups was measured within 24-48 hours after delivery. Results. A statistically significant higher value of cTnI (0.082 ?g/l ? 0.166) was found in group I than in the group III (healthy newborns). In the group I, 21/39 newborns required respiratory and 16/39 required pressure support. In the group II, the largest average value of cTnI of 0.425 ? 0.307 was found. All of the newborns in the group II required respiratory and pressure support. In the group III the lowest average value of cTnI (0.0186 ?g/L ? 0.0286) was found. Conclusions. High cTnI levels could be used as markers of perinatal asphyxia and even as predictors of future outcomes and/or mortality.

Disfunction of the left ventricle myocardium and its correction in premature infants with intrauterine pneumonia

1998 ◽  
Vol 79 (6) ◽  
pp. 416-418
Author(s):  
A. V. Gorshkov ◽  
O. I. Pikuza
Keyword(s):  
Cardiac Index ◽  
Left Ventricle ◽  
Premature Infants ◽  
Neonatal Period ◽  
Pump Function ◽  
Pronounced Decrease ◽  
Early Neonatal Period ◽  
Left Ventricle Myocardium

As many as 62 premature infants with intrauterine pneumonia are examined using echocardiography during early neonatal period. During the first 12 hours of life the disfunction of the left ventricle myocardium is diagnosed which is characterized by the pronounced decrease of the contractile and pump function, stroke and cardiac index of its myocardium. It is established that infusion of dapamine in dose of 58 mkg/ kg/ min provides the support of adequate contractility of the left ventricle myocardium and normalization of hemodynamics integral indices.

Can Cardiac Biomarkers (Troponin-I and CK-MB) Indicate Disease Severity and Predict Mortality in Septic Newborns?

2021 ◽  
Author(s):  
Ayşen Orman ◽  
Mustafa Maksut Altun ◽  
Samet Benli ◽  
Atika Çağlar ◽  
Erdal Taşkın ◽  
...  
Keyword(s):  
Gestational Age ◽  
Troponin I ◽  
Cardiac Biomarkers ◽  
Sepsis Group ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Long Term Prognosis ◽  
The Relationship

Abstract Aim: Sepsis is an important cause of morbidity and mortality for newborn babies. Cardiac involvement plays an important role in the pathophysiology of sepsis and has a significant effect on prognosis. In this study, the relationship between cardiac biomarkers, such as troponin-I (cTnI) and creatine kinase-myocardial band (CK-MB) levels, and prognosis in neonatal sepsis were investigated.Methods: A total of 87 patients with culture positive sepsis (Group I, n = 26) or clinical sepsis (Group II, n =61) were included in the study. The control group (Group III) consisted of 42 non-septic otherwise healthy newborns. The demographic data of the cases (gestational age, postnatal age, gender, age at diagnosis) and laboratory examination results (complete blood count, C-reactive protein, cTnI, CK-MB, blood gases and lactate and culture-antibiogram results) were recorded in the previously prepared study forms. In addition, the outcome (survival or death), and short- and long-term prognosis of the cases (epilepsy, neuromotor disability, vision-hearing problems, etc.) were also recorded.Results: No statistically significant difference was found between the groups in terms of gender, gestational age and birth weight. CK-MB level was high in 77%, 74%, and 71% of cases for Group I, Group II and Group III, respectively. No statistically significant difference was found in the rates of CK-MB levels in the patients who died and survived (15.8% and 11.8%, respectively) (p > 0.05). The cTnI cut-off value for the newborns included in the study was found to be 0.13 ng/ml (sensitivity 89.5%, specificity 90.9%). It was observed that a 0.001 unit increase in cTnI value (p =0.012) increased the risk of death 1.4 times.Conclusion: There is a relationship between cTnI test abnormality and mortality in septic newborns. However, multi-center studies involving more cases are needed to determine the relationship between cTnI test abnormality and long-term prognosis of patients.

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

2018 ◽  
pp. 107-110 ◽  
Author(s):  
O.A. Vazemiller ◽  
◽  
E.M. Vasileva ◽  
L.N. Karpova ◽  
A.B. Salmina ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
Neonatal Period ◽  
Transient Myocardial Ischemia

scholarly journals Absolute Neutropenia and Infection Development in Premature Infants in Early Neonatal Period: Cross-Sectional Study

2020 ◽  
Vol 19 (5) ◽  
pp. 352-358
Author(s):  
Vladimir E. Mukhin ◽  
Lyudmila L. Pankratyeva ◽  
Olga I. Mileva ◽  
Mikhael N. Yartsev ◽  
Nikolay N. Volodin
Keyword(s):  
High Risk ◽  
Cord Blood ◽  
Premature Infants ◽  
Phagocytic Activity ◽  
Neonatal Period ◽  
Stimulation Index ◽  
Infectious Complications ◽  
E Coli ◽  
Early Neonatal Period ◽  
Blood Neutrophils

Background. Premature infants have high risk of developing of neutropenia and infections in the early neonatal period. The correlation of these events requires further studies.Objective. The aim of the study was to investigate the frequency of absolute neutropenia and infectious complications cases in premature infants in the early neonatal period with estimation of phenotypical and functional features of cord blood neutrophils.Methods. The study included premature infants (gestational age 25–36 weeks) with APGAR score < 8 on the 1st and 5th minutes of life. The frequency of absolute neutropenia (at least once < 1.5109/l) and infectious complications (localized infections of bacterial etiology, early neonatal sepsis) cases in the first 14 day of life was analysed. Additionally, we have determined the expression of CD64, CD16, CD32 by cord blood neutrophils in premature (n = 102) and mature infants (n = 30) via method of flow cytofluorometry. We have used FITC labeled Escherichia coli to estimate their phagocytic activity, and stimulation of E. coli neutrophils in the presence of 5 mM of dihydrorhodamine 123 to estimate their stimulation index (ratio of mean fluorescent intensity (MFI) of activated neutrophils in stimulated samples and in negative controls, E. coli free samples).Results. The episodes of absolute neutropenia in the first 14 days of life were recorded in 17 cases, infectious complications — in 87 children (in 24 cases — sepsis) in the group of premature infants. The frequency of infectious complications in premature children did not correlate with the frequency of absolute neutropenia episodes. Cord blood neutrophils in premature infants had higher CD64 expression and, on the contrary, lower CD16 expression, as well as low phagocytic activity and stimulation index value (in all cases p < 0.001).Conclusion. Absolute neutropenia in premature infants in early neonatal period does not correlate with high risk of bacterial infections. However, cord blood neutrophils in premature infants had lower functional activity.

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