Correlation of Severity of Hypoxic–Ischemic Encephalopathy With Cardiac Dysfunction in Full-Term Neonates

Indu Mary Thomas, Nivedita Patil, Devayani Ajit Kulkarni, Saiprasad Onkareshwar Kavthekar, Ravindra Shamrao Pawar, Ramesh Maruti Nigade

Abstract

Background: The pathogenesis of perinatal asphyxia (PA) primarily affects the brain in the form of hypoxic–ischemic encephalopathy (HIE). However, PA can lead to multiorgan damage, involving cardiac dysfunction.

Aim: To determine the correlation between the severity of HIE and cardiac dysfunction in full-term neonates with PA

Materials and Methods: Forty full-term neonates who had clinical evidence of HIE were included. The severity of HIE was assessed using the Levene HIE grading. Clinical parameters for cardiac dysfunction, and electrocardiogram (ECG) and echocardiography (ECHO) findings were noted. The data were analyzed statistically.

Results: Mild, moderate, and severe HIE was observed in 50%, 27.5%, and 22.5% of the neonates, respectively. Cardiac dysfunction was present in 60% of the neonates with HIE. It was observed that 67.5% of the neonates had abnormal findings on the ECG (inverted T wave in 17.5%), of whom 77.78% had clinically evidenced cardiac dysfunction. We also observed that 65% of the neonates had abnormal findings on ECHO (moderate tricuspid regurgitation in 20%), of whom 76.9% had clinically evidenced cardiac dysfunction. A significant correlation was found between clinical manifestations of cardiac dysfunction, ECG, and ECHO abnormalities with HIE severity.

Conclusion: Bedside ECG and ECHO along with clinical monitoring in all neonates with HIE, especially with severe HIE, would help in early detection of cardiac dysfunction.