Journal of Pediatrics and Neonatal Care Correlation of Cord blood Cardiac Troponin-T to Echocardiographic and Tissue Doppler Variables in Infants of Diabetics Mothers with and without Hypertrophic Cardiomyopathy Submit Manuscript | http://medcraveonline.com Introduction Diabetes effects start in utero and affect neonates, infants, children and adolescent. Gestational diabetes may have overwhelming effects on the embryonic heart as well as the infants born to diabetic mothers. The neonates and infants suffering this metabolic disease may have considerable cardiovascular effects [1]. Hypertrophic cardiomyopathy is a well known condition observed in infants of diabetic mothers and described for the first time in a stillborn infant of a diabetic mother by Maron et al. 1978 [2]. It occurred in about 30-40% of them. However, clinically manifest hypertrophic cardiomyopathy is present in 12% of cases with severity varies from an incidental finding on echocardiography to an infant with severe symptoms of congestive heart failure. Fatal cases of hypertrophic cardiomyopathy may occur in any infant of a diabetic mother [3]. It characterized by stiff, hypertrophied ventricular muscle, predominant thickening of the ventricular septum, impaired relaxation, and powerful but uncoordinated contraction. Functional subaortic obstruction may occur in severe cases (idiopathic hypertrophic subaortic stenosis) [4]. The exact mechanism of hypertrophic cardiomyopathy in infants of diabetic mothers is clear but it is suggested that fetal hyperinsulinism may trigger hyperplasia and hypertrophy of myocardial cells by increasing fat and protein synthesis [5]. Natural history of infant of diabetic mother related-hypertrophic cardiomyopathy appeared to be benign, with a resolution of symptoms within 2-4 weeks and a resolution of septal hypertrophy within 2-12 months [6]. Color flow Doppler echocardiography is an effective diagnostic tool for the diagnosis of hypertrophic cardiomyopathy as it allows easy detection, and follow-up of its progression [7,8]. Tissue Doppler is sensitive in detecting diastolic dysfunction allowing early diagnosis of hypertrophic cardiomyopathy [9,10]. Volume 5 Issue 1 - 2016 1 Pediatric Department, Faculty of Medicine, Tanta University, Egypt 2 Faculty of Medicine, Menoufyia University, Egypt 3Pediatric Department, Faculty of Medicine, Tanta University, Egypt 4 Pathology Department, Ministry of Health, Kingdom of Bahrain *Corresponding author: Mohammed Al-Biltagi, Professor of Paediatrics, Paediatric Department, Faculty of Medicine, Tanta University, El Bahr Str, Tanta 31527, Egypt, Tel: +97- 33-9545472; Fax: +20-40-221354, Email: Received: July 29, 2016 | Published: August 10, 2016 Research Article J Pediatr Neonatal Care 2016, 5(1): 00171 Abstract Objective: The objective was to evaluate the value of cord blood cardiac troponin-T levels and tissue Doppler echocardiography in evaluation of hypertrophic cardiomyopathy in infants of diabetic mothers. Methods: A prospective study involved 60 infants of diabetic mothers and 60 healthy neonates. Cord blood level of cardiac troponin-T was measured and conventional and tissue Doppler echocardiographies were performed for all infants. Results: Hypertrophic cardiomyopathy was present in 19 cases (31.6%) of infants of diabetic mothers. There were significant increase in the cord blood cardiac troponin-T levels (P<0.0001) and more significant systolic and diastolic dysfunction in infants of diabetic mothers than in control group. Infants of diabetic mothers with hypertrophic cardiomyopathy had significant increase in the cord blood cardiac troponin-T levels (P<0.0001) and more significant systolic and diastolic dysfunction than infants of diabetic mothers without hypertrophic cardiomyopathy. There was no significant correlation between infant’s birth weight and cord blood cardiac troponin-T levels while there was significant correlation between maternal glycosylated hemoglobin and cord blood levels of cardiac troponin-T. There were significant negative correlation between cord blood levels of cardiac troponin-T and E/A ratio at mitral valve, E’/A’ ratio and S wave at mitral annulus, E/A ratio tricuspid valve, E’/A’ ratio and S wave at tricuspid annulus. There were positive correlations between cord blood cardiac troponin-T levels with septal/posterior wall, and Tie indices. Conclusion: cardiac troponin-T was a useful marker especially when combined with tissue Doppler echocardiography for evaluation of hypertrophic cardiomyopathy in infants of diabetic mothers. Keywords: Infants of Diabetic Mothers; Hypertrophic cardiomyopathy; Tissue Doppler; Cardiac troponin-T; Cord blood; Echocardiography