Cardiac Biomarkers and Myocardial Dysfunction in Septicemia
Deep Chandh Raja1, Sanjay Mehrotra2, Avinash Agrawal2
1Senior Resident.
The Journal of the Association of Physicians of India
|January 13, 2018
Summary
Cardiac biomarkers like troponin T and NT pro BNP predict sepsis mortality, while CPK MB correlates with myocardial dysfunction. These markers aid in assessing sepsis severity and patient outcomes.
Area of Science:
- Cardiology
- Critical Care Medicine
- Biochemistry
Background:
- Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Cardiac involvement, including myocardial dysfunction, is common in sepsis and associated with poor prognosis.
- The role of specific cardiac biomarkers in predicting sepsis severity, mortality, and myocardial dysfunction requires further investigation.
Purpose of the Study:
- To evaluate the association of cardiac biomarkers with sepsis severity, mortality, and myocardial dysfunction.
- To assess the predictive capabilities of troponin T (trop T), creatine phosphokinase MB isoform (CPK MB), and NT pro brain natriuretic peptide (NT Pro BNP) in septicemia.
- To determine the correlation between echocardiographically identified myocardial dysfunction and these biomarkers.
Main Methods:
- A case-control study involving 54 patients with septicemia and 54 controls.
- Measurement of serum levels of troponin T, CPK MB, and NT Pro BNP.
- Echocardiography to assess myocardial function in sepsis patients.
- Statistical analysis to correlate biomarker levels with clinical outcomes (severity, mortality) and echocardiographic findings.
Main Results:
- Cardiac biomarker levels (Troponin T, CPK MB, NT Pro BNP) were significantly elevated in septicemia patients compared to controls.
- Myocardial dysfunction was observed in approximately 50% of sepsis patients (27 out of 54).
- Troponin T and NT Pro BNP showed a strong association with higher mortality rates.
- CPK MB demonstrated a better correlation with myocardial dysfunction detected by echocardiography.
Conclusions:
- Myocardial dysfunction is a frequent complication in sepsis, identified in about half of the patients.
- Cardiac biomarkers are valuable tools for assessing sepsis severity, detecting myocardial injury, and prognostication.
- CPK MB is particularly useful for suspecting myocardial dysfunction in patients with septicemia.
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