Troponin T correlates with MRI results in neonatal encephalopathy

Acta Paediatr. 2020 Nov;109(11):2266-2270. doi: 10.1111/apa.15255. Epub 2020 Apr 13.


Aim: Troponin is a sensitive marker of asphyxia in term infants mirroring the myocardial injury sustained in global hypoxia-ischaemia. In addition, troponin is a sensitive marker of severity of stroke in adults and neonatal encephalopathy (NE). We aimed to examine the relationship between troponin T in infants with perinatal asphyxia and brain injury on MRI and correlate with neurodevelopmental outcome.

Methods: Serum troponin was sampled in infants requiring resuscitation at birth and/or neonatal encephalopathy in a tertiary referral neonatal centre. Birth history, clinical parameters, neuroimaging and developmental outcome (Bayley Scores of Infant Development [BSID] III) were evaluated.

Results: Infants with perinatal asphyxia (n = 54) had serum troponin T measured and 27 required therapeutic hypothermia. Troponin T levels on days 1 and 2 were predictive of need for TH, development of seizures and grade II/III NE (AUC = 0.7; P-values < .001), troponin T levels on days 1, 2 and 3 were highly significant predictors of mortality (AUC = 0.99, P-values .005). The cut-off values of troponin T for best prediction of mortality were 0.84, 0.63 and 0.58 ng/mL on days 1, 2 and 3, respectively. Troponin T on day 3 of life was predictive of injury in the combined area of basal ganglia/watershed on MRI (AUC 0.70; P-value = .045).

Conclusion: Infants with brain injury on neuroimaging following perinatal asphyxia had significantly elevated serum troponin, and troponin also correlated with developmental scores at 2 years. Further studies combining troponin and MRI may assist in the classification of neonatal brain injury to define aetiology, prognosis and response to treatment.

Keywords: cytokines; hypoxic-ischaemic encephalopathy; neonatal brain injury; perinatal asphyxia; therapeutic hypothermia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asphyxia Neonatorum* / complications
  • Asphyxia Neonatorum* / diagnostic imaging
  • Asphyxia Neonatorum* / therapy
  • Child
  • Female
  • Humans
  • Hypothermia, Induced*
  • Hypoxia-Ischemia, Brain* / diagnostic imaging
  • Hypoxia-Ischemia, Brain* / therapy
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Pregnancy
  • Troponin T


  • Troponin T