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Abstract
Background. Neonatal arrhythmias, for the most part, have a good prognosis for recovery. However, they can also have an adverse course and lead to the development of life-threatening conditions. Therefore, it is important to search for earlier markers of myocardial lesion, diagnostic criteria and predictors of arrhythmias. Purpose. Improvement of diagnosis and prediction of the risk of cardiac arrhythmias and conduction in newborns in the early neonatal period by identifying factors that play a role in the prediction of neonatal arrhythmias. Subjects & Methods. The study involved 76 newborns. Group 1 included 57 infants with arrhythmias according to Holter monitoring, Group 2 included 19 infants without arrhythmias. The study implied a comparison of history data, laboratory and instrumental findings, levels of troponin I and copeptin. To predict the development of neonatal arrhythmias, logistic regression analysis was performed. The quality of the model was tested using the Percent Concordant (PC). Quality Score was evaluated by R2 Nigelkerke. Model adequacy was estimated using the Hosmer-Lemeshow test. Results. The study showed that the factors that can influence the development of arrhythmias in the early neonatal period are the level of umbilical cord blood, the levels of troponin I, copeptin, GGT, assessment of Apgar scale in the 1st and 5th minutes, asphyxia at birth, indices of wave R amplitude in V3 and V5 of chest leads, ST segment deviation from the isoline according to standard surface ECG, QTc levels and mean daily maximum, minimum heart rate according to Holter monitoring. Conclusions. Predictors of neonatal arrhythmias development are indicators of laboratory-instrumental parameters of cardiovascular system status, troponin I level above 0.29 ng/ml and copeptin level above 0.1 ng/ml.
References
Ban, J.-E. (2017). Neonatal arrhythmias: diagnosis, treatment, and clinical outcome. Korean. J. Pediatr, 60(11), 344-352. doi: 10.3345/kjp.2017.60.11.344
Silva, A., Soares, P., Flor-de-Lima, F., Moura, C., Areias, J. C., Guimarães, H. (2016). Neonatal arrhythmias – morbidity and mortality at discharge. Journal of Pediatric and Neonatal Individualized Medicine, 5(2). doi: 10.7363/050212
Shikuku, D. N., Benson, M., Ayebare, E. (2018). Practice and outcomes of neonatal resuscitation for newborns with birth asphyxia at Kakamega County General Hospital, Kenya: a direct observation study. BMC Pediatr, 18, 167. doi:10.1186/s12887-018-1127С6
Morales, P., Bustamante, D., Espina-Marchant, P., Neira-Pena, T., Gutierrez-Hernandez, M. A., Allende-Castro, C, Rojas-Mancilla, E. (2011). Pathophysiology of perinatal asphyxia: can we predict and improve individual outcomes? EPMA J, 2(2), 211-30.
Jaeggi, E., Оhman, A. (2016). Fetal and Neonatal Arrhythmias. Clin. Perinatol, 43, 99-112. Retrieved from http://dx.doi.org/10.1016/j.clp.2015.11.007
Costa, S., Zecca, E., De Rosa, G., De Luca, D., Barbato, G., Pardeo, M., Romagnoli, C. (2007). Is serum troponin T a useful marker of myocardial damage in newborn infants with perinatal asphyxia? Acta Paediatr, 96(2), 181-4.
Suzuki, K., Komukai, K., Nakata, K., Kang, R., Oi, Y., Muto, E. (2018). The Usefulness and Limitations of Point-of-care Cardiac Troponin Measurement in the Emergency Department. Intern Med, 57(12), 1673-80.
Cabral, M., Leite-Moreira, A., Monterroso, J., Ramalho, C., Guimarães, H. (2016). Myocardial Injury Biomarkers in Newborns with Congenital Heart Disease. Pediatr. Neonatol, 57 (6), 488-495. doi: 10.1016/j.pedneo.2015.11.004.
Cai, F., Li, M. X., Pineda-Sanabria, S. E., Gelozia, S., Lindert, S., West, F., Sykes, B. D., Hwang, P. M. (2016). Structures reveal details of small molecule binding to cardiac troponin. Journal of Molecular and Cellular Cardiology, 101, 134-144.
Bolignano, D., Cabassi, A., Fiaccadori, E., Ghigo, E., Pasquali, R., Peracino, A., Peri, A., Plebani, M., Santoro, A., Settanni, F., Zoccali, C. (2014). Copeptin (CTproAVP), a new tool for understanding the role of vasopressin in pathophysiology. Clinical Chemistry and Laboratory Medicine, 52(10), 1447-56.
Baumert, M., Surmiak, P., Wiecek, A., Walencka, Z. (2017). Serum NGAL and copeptin levels as predictors of acute kidney injury in asphyxiated neonates. Clinical and Experimental Nephrology, 21, 658–664.
Rey, C., García-Cendón, C., Martínez-Camblor, P., López-Herce, J., Concha-Torre, A., Medina, A., Vivanco-Allende, A., Mayordomo-Colunga, J. (2016). High levels of atrial natriuretic peptide and copeptin and mortality risk. Anales de Pediatría, 85(6), 284-290.
Kelen, D., Andorka, C., Szabо, M., Alafuzoff, A., Kaila, K., Summanen, M. (2017). Serum copeptin and neuron specific enolase are markers of neonatal distress and long-term neurodevelopmental outcome. PLoS One, 12(9), e0184593.
Summanen, M., Seikku, L., Rahkonen, P., Stefanovic, V., Teramo, K., Andersson, S., Kaila, K., Rahkonen, L. (2017). Comparison of Umbilical Serum Copeptin Relative to Erythropoietin and S100B as Asphyxia Biomarkers at Birth. Neonatology, 112(1), 60-66.
Krakauer, M. G., Gowen, C. W. (2020-2019). Birth Asphyxia. Jr StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28613533
Drago, F., Battipaglia, I., Mambro, D. (2018). Neonatal and Pediatric Arrhythmias: Clinical and Electrocardiographic Aspects. Card Electrophysiol Clin, 10(2), 397-412. doi: 10.1016/j.ccep.2018.02.008
Hodovanets, Yu. D., Peryzhniak, A. I. (2016). Pathogenetic aspects of cardiovascular disorders in newborn infants with hypoxic defeats. Neonatology, surgery and perinatal medicine, 1(19), 21-26.
Artyomova, N. S., Korobka, O.V., Pokhylko, V. I., Tsvirenko, S. M., Kovalova O. M. (2017). Integrated model for the prediction of organic dysfunctions development in newborns with asphyxia and applied points of its implementation. Neonatology, surgery and perinatal medicine, 4(26), 24-30.
Method for differential diagnosis of cardiac arrhythmias and conduction in early neonatal period in premature infants with intraventricular hemorrhage. Retrieved from http://uapatents.com/5-111557-sposib-diferencialno-diagnostiki-porushen-sercevogo-ritmu-ta-providnosti-v-rannomu-neonatalnomu-periodi-u-peredchasno-narodzhenikh-ditejj-z-vnutrishnoshlunochkovimi-krovovilivami.html
Method for differential diagnosis of cardiac arrhythmias and conduction in term neonates with asphyxia. Retrieved from http://lib.inmeds.com.ua:8080/jspui/handle/lib/10308
A method for predicting the outcome of posthypoxic disorders of the cardiovascular system in newborns. Retrieved from https://findpatent.ru/patent/242/2423072.html
Method for predicting risk of development of severe post-hypoxic myocardial damage in newborns with different period of gestation in the neonatal period. Retrieved from https://rusneb.ru/catalog/000224_000128_2013115182_20141010_A_RU/
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