Prognostic significance of myocardial markers and echocardiography in elderly patients with sepsis

Abstract

Objective To explore the relationship between those myocardial markers serum cardiac troponin T (cTNT), serum cardiac troponin I (cTNI) , N-terminal pro-brain natriuretic peptide (NT-proBNP), echocardiography and myocardial injury in the oldest-old septic patients, as well as to evaluate prognosis in the oldest-old septic patients. Methods 140 oldest-old septic patients hospitalized in Beijing Friendship Hospital from January 1st, 2015 to Jun 31st, 2017 were collected and analyzed retrospectively. They were divided into survival group (90 cases) death group (50 cases)according to their survival time. Serum cTNT, cTNI and NT-proBNP level at 1, 3 and 7d post-diagnosis were collected and echocardiography left ventricular diastolic diameter (EDD), left ventricular systolic diameter (ESD), right ventricular diameter (RV), left ventricular ejection fraction (EF) was performed. Results 140 oldest-old septic patients were enrolled in the analysis. There were 90 cases in survival group and 50 cases in death group. Mean values of cTNT, cTNI, NT-proBNP, EDD, ESD in survival group were obviously higher than those in death group (P 0.05). There were positive correlation between cTNT, cTNI, NT-proBNP and EDD, ESD (P 0.05). There were obviously correlation between cTNT, cTNI, NT-proBNP, EDD, ESD and mortality rate (OR>1, P NT-proBNP>cTNI>EDD>ESD. Conclusions There were obviously correlation between cT NT, cTNI, NT-proBNP, EDD, ESD and myocardium restrain, heart dysfunction as well as mortality rate. cTNT was the best prognosis indicator in sensitivity, and NT-proBNP was the best prognosis indicator in specificity. The combination of cTNT and NT-proBNP can better forecast the prognosis of the oldest-old septic patient. Key words: Sepsis/ME/US; Troponin I/ME; Troponin T/ME; Natriuretic peptide, brain/ME; Echocardiography; Aged