Monographic Research·Diagnosis and Treatment of Disease in Emergency Department
Prognostic significance of myocardial markers and echocardiography in elderly patients with sepsis
Zhang Hanyu, Deng Yanjun, Li Zhenhua, Sun Xuelian, Wang Guoxing, Xie Miaorong, Li Chunsheng
Published 2018-05-20
Cite as J Chin Physician, 2018,20(5): 644-648. DOI: 10.3760/cma.j.issn.1008-1372.2018.05.002
Abstract
ObjectiveTo 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.
Methods140 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.
Results140 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), left ventricular ejection fraction (LVEF) in survival group was lower than that in death group (P<0.01). But there were no difference in E/A and RV between survival group and death group (P>0.05). There were positive correlation between cTNT, cTNI, NT-proBNP and EDD, ESD (P<0.05), negative correlation between cTNT, cTNI, NT-proBNP and LVEF (P<0.05), and no correlation between cTNT, cTNI, NT-proBNP and E/A, RV (P>0.05). There were obviously correlation between cTNT, cTNI, NT-proBNP, EDD, ESD and mortality rate (OR>1, P<0.05). It was shown the prognosis value of cTNT, cTNI, NT-proBNP, EDD, ESD to mortality rate in oldest-old septic patient. The prognosis value was cTNT>NT-proBNP>cTNI>EDD>ESD.
ConclusionsThere 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
Contributor Information
Zhang Hanyu
Department of Emergrncy, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Deng Yanjun
Li Zhenhua
Sun Xuelian
Wang Guoxing
Xie Miaorong
Li Chunsheng
