الفهرس 
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Abstract
The aim of this study was to compare cTnT concentration among healthy neonates and those with respiratory distress; and to detect whether any correlation could occur between severity of respiratory distress, need for inotropes and troponin concentrations. Echocardiographic assessment of cardiac function of the neonates with respiratory distress was also correlated with troponin concentrations.
This study was carried out in the neonatal intensive care units (NICU) of both Pediatrics and Gynecology & Obstetrics departments of Ain Shams University hospitals in the period from April 2010 to March 2011. The study was approved by the ethical committee of Ain Shams University and National Research Center.
It included a study group of 25 newborns with respiratory distress, i.e. with tachypnea, subcostal and intercostal retractions, and those requiring supplemental oxygen or mechanical ventilation, to keep oxygen saturation on pulse oximeter above 94% and to keep PCo2 in arterial blood gases between 35-45mmHg; and a control group of 25 apparently healthy newborns without respiratory distress, i.e. those breathing spontaneously in air without support, with normal respiratory rate and normal work of breathing.
Neonates with congenital cardiac malformations, intrauterine growth retardation or severe asphyxia at birth, were excluded from the study.
All newborns included in the study were subjected to full perinatal history, complete clinical assessment and laboratory and radiological workups.
In the present study, there was no significant difference between cases and controls as regards GA, BWt, sex distribution, mode of delivery, presence of PROM or PET and age at sampling of cTnT; but there was highly significant difference between the two groups as regards Apgar score at 1min and significant difference as regards Apgar score at 5min; both being lower in the cases group.
In addition, there was highly significant difference in levels of cTnT between cases and controls groups, being higher in the cases group.
As regards the clinical outcome of the included neonates, there was highly significant difference in duration of hospital stay between cases and control groups, being longer in the cases group. Fifty-six percent of cases needed mechanical ventilation while 44% didn’t; and there was highly significant difference between levels of cTnT in ventilated and non-ventilated cases, being higher in the ventilated cases. Sixteen percent of cases needed inotropic support while 84% didn’t; and there was significant difference between levels of cTnT in cases who needed inotropic support and those who didn’t, being higher in cases who needed inotropic support. Twenty percent of cases died while 80% survived; and there was highly significant difference between levels of cTnT in cases who died and those who survived, being higher in cases who died.
The current study showed no significant correlation between levels of cTnT and GA, BWt, sex distribution, presence of PROM, PET or RDS, Apgar score at 1 and 5min, acid-base status, age at sampling and duration of hospital stay.
On the other hand, there was significant positive correlation between levels of cTnT and duration of inotropic support; and highly significant positive correlation between levels of cTnT and both durations of respiratory support and ventilation. Also, that there was significant positive correlation between levels of cTnT and MAP; and highly significant positive correlation between levels of cTnT and OI.
As regards echocardiographic data, there was highly significant negative correlation between levels of cTnT and LVFS; while no significant correlation was found with LVO.