NT-proBNP, Echocardiography Patterns and Outcomes in Sepsis-Induced Cardiac Dysfunction

Area of Science:

• Cardiology
• Intensive Care Medicine
• Biomarkers

Background:

• Sepsis-induced cardiac dysfunction (SICD) is a reversible condition with unclear incidence and prognostic impact.
• Understanding SICD's features and outcomes is crucial for sepsis management.

Purpose of the Study:

• To identify SICD in ICU patients with sepsis or septic shock.
• To characterize clinical and paraclinical features of SICD.
• To analyze SICD patterns and determine prognostic implications.

Main Methods:

• Retrospective analysis of 128 ICU patients with sepsis/septic shock undergoing echocardiography.
• Exclusion of patients with myocardial infarction or pre-existing severe heart conditions.
• Documentation of clinical, paraclinical, and echocardiographic data; primary outcome: composite of mortality, prolonged hospital/ICU stay.

Main Results:

• 37% of patients developed SICD; risk factors included alcohol abuse, vasopressor therapy, and intubation.
• Four distinct echocardiographic patterns of cardiac dysfunction were identified.
• Elevated NT-proBNP (>9000 pg/mL) predicted SICD, composite outcomes, and mortality.
• SICD predicted the composite outcome but not mortality directly; 44% in-hospital mortality.

Conclusions:

• This study details SICD incidence and spectrum in tertiary care sepsis patients.
• Sepsis-associated cardiac dysfunction and elevated NT-proBNP are significant prognostic indicators.
• High NT-proBNP levels are strongly associated with adverse outcomes in sepsis.