Abstract
Background Left ventricular systolic dysfunction (LVSD) is common in sepsis. Speckle-tracking echocardiography (STE) is a useful emerging tool for evaluating the intrinsic left ventricular systolic function. High-sensitivity cardiac troponin T (hs-cTnT) is the most sensitive biomarker of myocardial injury. However, there are limited data regarding the association between hs-cTnT level and left ventricular systolic dysfunction based on STE in septic patients. We performed this prospective study to evaluate the diagnostic value of hs-cTnT level for subclinical left ventricular systolic dysfunction measured by STE in septic patients according to the sepsis-3 definition. Methods Patients with sepsis based on sepsis-3 definition admitted to the intensive care unit were prospectively performed STE and hs-cTnT level within 24 hours after the onset of sepsis. Baseline clinical and echocardiographic variables were collected. Left ventricular systolic dysfunction was defined as a global longitudinal strain of ≥−15%. Results During a 19-month period, 116 patients were enrolled in the study. The elevated hs-cTnT level was seen in 86.2% of septic patients, and 43.1% of patients had LVSD on STE. The median hs-cTnT level and the proportion of elevated hs-cTnT level (>14 ng/L) were significantly higher in patients with LVSD than in patients without LVSD. The area under the ROC curves of hs-cTnT to detect LVSD was 0.73 (P < 0.001). In the multivariate analysis, hs-cTnT (HR, 1.002; 95% CI, 1.000 to 1.004; P = 0.025) and septic shock (HR, 7.6; 95% CI, 2.25 to 25.76; P = 0.001) were independent predictors of LVSD. Conclusion Our study indicated that the serum hs-cTnT level might be a useful biomarker for detecting LVSD in septic patients.
Highlights
Sepsis is one of the leading causes of mortality in the intensive care unit, as it is often associated with multiorgan failure [1, 2]. e heart is a commonly affected organ in sepsis
Eleven were excluded from analysis due to a lack of High-sensitivity cardiac troponin T (hs-cTnT) level measurements. e remaining 116 patients were eligible for assessment
Acute Physiology and Chronic Health (APACHE) II and SOFA scores were significantly higher in patients with left ventricular (LV) systolic dysfunction than those with normal LV function (P < 0.05). e proportion of patients with Left ventricular systolic dysfunction (LVSD) receiving mechanical ventilation and continuous renal replacement therapy was higher than patients without LVSD (P < 0.05)
Summary
Sepsis is one of the leading causes of mortality in the intensive care unit, as it is often associated with multiorgan failure [1, 2]. e heart is a commonly affected organ in sepsis. Left ventricular global longitudinal strain (GLS) measured by speckle-tracking echocardiography is more reliable, reproducible, and Cardiology Research and Practice sensitive than LVEF in detecting systolic myocardial dysfunction [12, 13]. Speckle-tracking echocardiography (STE) is a useful emerging tool for evaluating the intrinsic left ventricular systolic function. There are limited data regarding the association between hs-cTnT level and left ventricular systolic dysfunction based on STE in septic patients. We performed this prospective study to evaluate the diagnostic value of hs-cTnT level for subclinical left ventricular systolic dysfunction measured by STE in septic patients according to the sepsis-3 definition. Our study indicated that the serum hs-cTnT level might be a useful biomarker for detecting LVSD in septic patients
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.