Diagnostic Value of High-Sensitivity Troponin T for Subclinical Left Ventricular Systolic Dysfunction in Patients with Sepsis.

Autor: Hai PD; Intensive Care Unit, 108 Military Central Hospital, Hanoi, Vietnam., Binh NT; Intensive Care Unit, 108 Military Central Hospital, Hanoi, Vietnam., Tot NH; Intensive Care Unit, 108 Military Central Hospital, Hanoi, Vietnam., Hung HM; Intensive Care Unit, 108 Military Central Hospital, Hanoi, Vietnam., Hoa LTV; Intensive Care Unit, Tam Anh Hospital, Hanoi, Vietnam., Hien NVQ; Department of Anesthesiology and Critical Care Medicine, Hue Central Hospital, Hue, Vietnam., Son PN; Department of Cardiology, 108 Military Central Hospital, Hanoi, Vietnam.
Jazyk: angličtina
Zdroj: Cardiology research and practice [Cardiol Res Pract] 2021 Apr 23; Vol. 2021, pp. 8897738. Date of Electronic Publication: 2021 Apr 23 (Print Publication: 2021).
DOI: 10.1155/2021/8897738
Abstrakt: 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.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2021 Pham Dang Hai et al.)
Databáze: MEDLINE
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