Abstract:

Purpose: The purpose of therapeutic therapy is to evaluate the cardiovascular findings of hypoxic ischemic encephalopathy (HIE) newborns; by biobelirects, ECG and ecocardiography, and to investigate the effect of these indicators on the determination of the severity of hypoxic myocardial damage. Tools and Methods: The data of 50 newborn babies diagnosed in stages II and III with therapeutic hyperthermia was examined retrospectively. Demographic characteristics, systemic and cardiovascular examination findings, serum CK-MB, troponin-I, ECG and ecocardiography reports were recorded. Patients of Phase II and Phase III have been compared. Results: 11 of the fifty incidents (22%) found myocardial dysfunction. All events in the ECG records had a normal sinus rhythm. The pathological findings in the ECG were present in 2 (8.3%) in stage II and 5 (19.8%) in stage III. Serum CK-MB and troponin-I were observed high in 30 cases (60%). In 5 of all cases (%10) there was a moderate trichuspithic insufficiency, in 1 (%2) a severe trichuspithic insufficiency, in 4 (%8) a right ventricular hypochynesis, in 6 (%12) a left ventricular hypochynesis and in 1 (%2) a biventricular hypochynesis. In phase III, the enzyme levels were higher, and ECG and EKO abnormalities were more common (p<0.05). Result: Hypoxic ischemic encephalopathy in newborns is extremely important for the prognosis of heart effects. Heart assessment and close follow-up are very important for better management of treatment in cases. Cardiological biobelirects, ECG and EKO are useful in the early diagnosis and evaluation of the severity of myocardial damage in perinatal asphyxide.

Keywords:

Abstract:

Objective: The aim of this study is to evaluate the severity of cardiac complications of hypoxic ischemic encephalopathy (HIE) according to the degree of hypoxia and to evaluate the efficacy of cardiac biomarkers, electrocardiography (ECG) and echocardiography (ECHO) for myocardial injury. Material and Methods: Fifty term babies with HIE without any additional disease were selected. Myocardial dysfunction was evaluated using clinical examination, serum CK-MB, troponin-I and ECG and ECHO. Results: According to Sarnat and Sarnat classificiation, 24 neonates were diagnosed stage II and 26 neonates were diagnosed stage III HIE. Among these 50 cases, 11 (22%) had evidence of myocardiac dysfunction. All the cases had normal sinus rhythm. ECG changes (ST depression, T wave inversion, pathological Q wave as signs of ischemia) were present in 2 (8.3%) cases in the stage II, and 5 (19.8%) cases in the stage HIE group. ECG showed. Serum levels of troponin-I and CK-MB were increased in 30 (60%) patients. Moderate tricuspid regurgitation was present in 5 (10%), severe tricuspid regurgitation in 1 (2%), right ventricular hypokinesia in 4 (8%), left ventricular hypokinesia in 6 (12%) and biventricular hypokinesia in 1 (2%) neonate among all the cases. Enzyme levels were higher, ECG and ECHO abnormalities were more common in the neonates with stage III HIE (p<0.05). Conclusion: Cardiac involvement is extremely important in terms ofprognosis in the neonates with HIE. Cardiac evaluation and close followup should be performed for the better management of HIE. Cardiac biomarkers, ECG and ECHO are useful in the early recognition and evaluating the severity of myocardial damage in perinatal asphyxia.