Hindawi Publishing Corporation International Journal of Pediatrics Volume 2012, Article ID 479242, 5 pages doi:10.1155/2012/479242 Clinical Study Cardiac Troponin T and Illness Severity in the Very-Low-Birth-Weight Infant Danielle N. Lopes,1 Jose´ M. Moraes Ramos,2 Maria Elizabeth Lopes Moreira,2 Jofre A. Cabral,1 Manoel de Carvalho,1 and Jose´ Maria de Andrade Lopes1, 2 1 Neonatal Intensive Care Unit, Cl´ınica Perinatal Laranjeiras, 22240-002 Rio de Janeiro, Brazil 2 Department of Neonatology, Instituto Fernandes Figueira, Oswaldo Cruz Foundation, 22250-020 Rio de Janeiro, Brazil Correspondence should be addressed to Jose´ Maria de Andrade Lopes, jmlopes@perinatal.com.br Received 1 September 2011; Revised 23 November 2011; Accepted 12 December 2011 Academic Editor: Khalid N. Haque Copyright © 2012 Danielle N. Lopes et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Respiratory distress are very common in Very-low-birth-weight (VLBW) infants and Myocardial injury may play a role in the disease outcome. Cardiac troponin T (cTnT) is the most useful marker of injury in adult population, but has not been extensively studied in this population. Aim. To study the role of cTnT in VLBW infants and its association with clinical outcomes. Methods. All VLBW infants admitted to our NICU were included in the study. Echocardiography and blood samples for cTnT determination were collected at 24 and 48 hours of life, and values >0.1 ng/mL were considered CTnT-positive values. Results. A total of 116 neonates had their blood samples collected. The median cTnT concentration within 24 hours was 0.191 (0.1–0.79) ng/mL and within 48 hours was 0.293 (0.1–1.0) ng/mL. A logistic regression analysis showed that PDA, low GA, and use of dopamine were independently associated with positive cTnT and abnormal Dopplerﬂuxometry and diuretics use had protective eﬀects and was independently associated with troponin values. Conclusion. We observed a high prevalence of positivecTnT values in VLBW infants associated with illness severity. Our ﬁndings suggest that cTnT may be a useful and early marker of myocardial injury in VLBW infants. 1. Introduction Signiﬁcant therapeutic and technological progress have occurred in the intensive neonatal care in the last decades, but the care of very-low-birth-weight (VLBW) newborns still remains a big challenge. These premature newborns are very often in critical conditions, are immature, and represent more than 50% of neonatal deaths [1]. RDS aﬀects close to 50% of the VLBW infants; signs and symptoms of respiratory and cardiovascular disease are very similar [2], and decreased myocardial function and low car- diac output are common complications of conditions such as respiratory distress syndrome and perinatal asphyxia [3]. The cardiac troponin T (cTnT) is the best biochemical marker for myocardial ischemia in adults. Its blood level increases within two hours after a myocardial infarct and may remain elevated for two weeks [4]. The initial studies conducted in children and newborns used less sensitive assays—of ﬁrst and second generation, and the results of the cTnT were frequently negative. Most studies that used the third-generation assays seem more promising and have shown high levels of cTnT in infants with asphyxia, respiratory distress, and hypotension although there are still very few data for very-low-birth-weight infant [5, 6]. We designed this prospective study to assess the role of cTnT in the ﬁrst 48 hours of life and its association with clinical outcomes in a population of very-low-birth-weight infants. 2. Methods We prospectively studied all infants with birth weight less than 1500 g, admitted to the Neonatal Intensive Care Unit of Laranjeiras Perinatal Clinic, between January 2004 and July 2005. Infants with congenital malformation or genetic