Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease

Troponin I, myoglobin, and creatine kinase-MB mass (CK-MB) are biomarkers of cardiomyocyte injury widely used in the management of adult patients. The role of these biomarkers in newborns is still not established. The purpose of this study was to evaluate the value of cardiac injury biomarkers in ne...

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Main Authors: Ana Luisa Neves, Maria Cabral, Adelino Leite-Moreira, José Monterroso, Carla Ramalho, Hercília Guimarães, Henrique Barros, João T. Guimarães, Tiago Henriques-Coelho, José C. Areias
Format: Article
Language:English
Published: Elsevier 2016-12-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957216300195
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author Ana Luisa Neves
Maria Cabral
Adelino Leite-Moreira
José Monterroso
Carla Ramalho
Hercília Guimarães
Henrique Barros
João T. Guimarães
Tiago Henriques-Coelho
José C. Areias
author_facet Ana Luisa Neves
Maria Cabral
Adelino Leite-Moreira
José Monterroso
Carla Ramalho
Hercília Guimarães
Henrique Barros
João T. Guimarães
Tiago Henriques-Coelho
José C. Areias
author_sort Ana Luisa Neves
collection DOAJ
description Troponin I, myoglobin, and creatine kinase-MB mass (CK-MB) are biomarkers of cardiomyocyte injury widely used in the management of adult patients. The role of these biomarkers in newborns is still not established. The purpose of this study was to evaluate the value of cardiac injury biomarkers in newborns with congenital heart disease. Methods: From August 2012 to January 2014, 34 newborns with a prenatal diagnosis of congenital heart disease were admitted consecutively to a neonatal intensive care unit. As controls, 20 healthy newborns were recruited. Plasma levels of cardiac biomarkers (troponin I, myoglobin, and CK-MB) were evaluated, and echocardiography was performed to evaluate cardiac function on D 1. Patients were followed during the first 28 days of life and, according to outcome, categorized as surgical or conservative treatment group. Results: Median (P25–75) levels of CK-MB were higher in patients who underwent cardiac surgery in the neonatal period [7.35 (4.90–13.40) ng/mL] than in patients who were discharged home without surgery [4.2 (2.60–5.90) ng/mL; p = 0.032]. A CK-MB cutoff of ≥ 4.6 ng/mL showed sensitivity of 87.5% and specificity of 63.6%. Troponin I and myoglobin levels were not significantly different between conservative and surgical treatment groups. CK-MB levels correlated with the tissue Doppler image of the mitral valve lateral annulus peak early/late diastolic velocity ratio (ρ = −0.480, p = 0.018). Conclusion: CK-MB levels during the first hours of life were higher in newborns that needed neonatal cardiac surgery, and these levels may be an indicator of myocardial diastolic function.
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spelling doaj-art-a21496022df04522ae75a0d131bb80af2025-08-20T02:20:55ZengElsevierPediatrics and Neonatology1875-95722016-12-0157648849510.1016/j.pedneo.2015.11.004Myocardial Injury Biomarkers in Newborns with Congenital Heart DiseaseAna Luisa Neves0Maria Cabral1Adelino Leite-Moreira2José Monterroso3Carla Ramalho4Hercília Guimarães5Henrique Barros6João T. Guimarães7Tiago Henriques-Coelho8José C. Areias9Department of Paediatric Cardiology, São João Hospital, Porto, PortugalEPI Unit—Institute of Public Health, University of Porto, Porto, PortugalDepartment of Physiology and Cardiothoracic Surgery, Cardiovascular Research Centre, Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Paediatric Cardiology, São João Hospital, Porto, PortugalDepartment of Physiology and Cardiothoracic Surgery, Cardiovascular Research Centre, Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Physiology and Cardiothoracic Surgery, Cardiovascular Research Centre, Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Physiology and Cardiothoracic Surgery, Cardiovascular Research Centre, Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Physiology and Cardiothoracic Surgery, Cardiovascular Research Centre, Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Paediatrics, Faculty of Medicine, University of Porto, Porto, PortugalDepartment of Paediatric Cardiology, São João Hospital, Porto, PortugalTroponin I, myoglobin, and creatine kinase-MB mass (CK-MB) are biomarkers of cardiomyocyte injury widely used in the management of adult patients. The role of these biomarkers in newborns is still not established. The purpose of this study was to evaluate the value of cardiac injury biomarkers in newborns with congenital heart disease. Methods: From August 2012 to January 2014, 34 newborns with a prenatal diagnosis of congenital heart disease were admitted consecutively to a neonatal intensive care unit. As controls, 20 healthy newborns were recruited. Plasma levels of cardiac biomarkers (troponin I, myoglobin, and CK-MB) were evaluated, and echocardiography was performed to evaluate cardiac function on D 1. Patients were followed during the first 28 days of life and, according to outcome, categorized as surgical or conservative treatment group. Results: Median (P25–75) levels of CK-MB were higher in patients who underwent cardiac surgery in the neonatal period [7.35 (4.90–13.40) ng/mL] than in patients who were discharged home without surgery [4.2 (2.60–5.90) ng/mL; p = 0.032]. A CK-MB cutoff of ≥ 4.6 ng/mL showed sensitivity of 87.5% and specificity of 63.6%. Troponin I and myoglobin levels were not significantly different between conservative and surgical treatment groups. CK-MB levels correlated with the tissue Doppler image of the mitral valve lateral annulus peak early/late diastolic velocity ratio (ρ = −0.480, p = 0.018). Conclusion: CK-MB levels during the first hours of life were higher in newborns that needed neonatal cardiac surgery, and these levels may be an indicator of myocardial diastolic function.http://www.sciencedirect.com/science/article/pii/S1875957216300195cardiac biomarkerscongenital heart diseaseechocardiographyoutcome
spellingShingle Ana Luisa Neves
Maria Cabral
Adelino Leite-Moreira
José Monterroso
Carla Ramalho
Hercília Guimarães
Henrique Barros
João T. Guimarães
Tiago Henriques-Coelho
José C. Areias
Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease
Pediatrics and Neonatology
cardiac biomarkers
congenital heart disease
echocardiography
outcome
title Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease
title_full Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease
title_fullStr Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease
title_full_unstemmed Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease
title_short Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease
title_sort myocardial injury biomarkers in newborns with congenital heart disease
topic cardiac biomarkers
congenital heart disease
echocardiography
outcome
url http://www.sciencedirect.com/science/article/pii/S1875957216300195
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