Diagnostic Signifi cance of Heart Biomarkers in Newborns with Neonatal Arrhythmias on the Background of Birth Asphyxia
Introduction. Birth asphyxia results in short- and long-term eff ects, the severity of which depends
on the duration and severity of metabolic disorders and, as a consequence, the degree of hypoxic
damage. The development of cardiac arrhythmias is considered as the primary factor in the
detection of adverse events after asphyxia. Early diagnostics and timely correction of the identifi ed
pathological changes in the cardiovascular system in the postnatal period can be a signifi cant factor
in reducing the incidence and severity of cardiovascular disorders in children in future.
Purpose. To improve the diagnostics of neonatal arrhythmias in new-borns after birth asphyxia on
the base of studying the levels of biomarkers of myocardial damage and their correlations with the
data of daily ECG and Doppler echocardiography.
Materials and methods. The study involved 94 new-borns examined in the early neonatal period.
Anamnesis data analysis, cord blood samples with determination of the levels of troponin I,
copeptin, ischemia-modifi ed albumin, daily ECG and Doppler echocardiography monitoring were
conducted in all new-borns.
Results and discussion. Depending on the Holter ECG results, new-borns were divided into
two groups: group 1 (n=58) – new-borns with arrhythmia, group 2 (n=36) – without arrhythmia.
Depending on the presence of asphyxia at birth, the groups 1 and 2 were divided into subgroups:
group 1a – new-borns with arrhythmia and asphyxia (n=42), group 1b – new-borns with arrhythmia
and without asphyxia (n=16), group 2a – new-borns without arrhythmia and with asphyxia (n=8),
group 2b – new-borns without arrhythmia and asphyxia (n=28).
The study of maternal anamnesis showed that the majority of mothers in the fi rst group had
obstetric complications and extragenital disorders, which became a signifi cant risk factor for the
arrhythmia development (RR=1.582, 95% СI (1.100; 2.274), χ2=9.641; p<0.002 and χ2=5.190; p<0.02). Interrelations were obtained between the levels of biochemical markers of the cord blood and data of daily ECG and Doppler echocardiography in new-borns with heart rhythm disorders after birth asphyxia. Conclusion. The analysis of laboratory and instrumental comparisons of the levels of cardiac biomarkers in new-borns at birth showed that determination of these cardiac markers lets to predict the development of cardiovascular disorders in new-borns, who suff ered asphyxia at birth.