Biochemical markers of cardiac injury in normal, surviving septic, or nonsurviving septic neonatal foals.
Authors: Slack Jo Ann, McGuirk Sheila M, Erb H N, Lien Laura, Coombs Dane, Semrad Susan D, Riseberg Ase, Marques Fernando, Darien Benjamin, Fallon Luke, Burns Phil, Murakami Mary Ann, Apple Fred S, Peek Simon F
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Cardiac Biomarkers in Septic Neonatal Foals Myocardial injury during neonatal sepsis has been documented in human medicine through cardiac biomarkers, yet equivalent reference data for foals has been lacking until now. This study established baseline values for cardiac troponin T and I (cTnT and cTnI) and cardiac creatine kinase (CKMB) in 52 healthy neonatal foals and compared them to 38 septic foals at a referral hospital, with 18 nonsurvivors. Septic foals demonstrated significantly elevated cTnT and CKMB concentrations compared with healthy controls—notably, cTnT was detectable in 40% of septic foals versus only 17% of healthy foals, whilst median CKMB rose from 2.3 to 4.4 ng/mL—confirming that myocardial injury occurs during equine neonatal sepsis. Unexpectedly, these markers did not differ between septic foals that survived and those that died, suggesting that whilst cardiac involvement accompanies septicaemia in neonatal foals, the degree of biomarker elevation does not predict outcome. For practitioners, these findings provide clinically useful reference ranges for interpreting cardiac biomarkers in sick neonates and indicate that elevated troponins or CKMB in a septic foal warrant recognition of myocardial involvement, though prognosis cannot be determined from these markers alone.
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Practical Takeaways
- •Cardiac biomarkers (especially cTnT and CKMB) can detect myocardial injury in septic neonatal foals, but elevated values alone should not be used to predict survival or guide prognostic decisions.
- •Established reference ranges for cTnI, cTnT, and CKMB in healthy neonatal foals enable better interpretation of results when cardiac injury is suspected.
- •While sepsis causes measurable cardiac damage in foals, this finding does not change treatment intensity or prognosis prediction in clinical practice.
Key Findings
- •Normal reference ranges established for cardiac troponin I (cTnI: 0.08-0.49 ng/mL), cardiac troponin T (cTnT: 0.009-0.041 ng/mL), and CKMB (1.4-7.4 ng/mL) in healthy neonatal foals.
- •Septic foals showed significantly elevated cTnT and CKMB compared to healthy foals, indicating myocardial injury occurs during septicemia.
- •No significant differences in cardiac biomarker values were found between septic foals that survived versus those that died, suggesting cardiac injury is not predictive of survival outcomes in neonatal sepsis.