Troponin I as a diagnostic biomarker of left ventricular dysfunction in septic patients:a prospective study

Abstract

Background: One of sepsis's most well known side effects is decreased left ventricular systolic function. In the first stages of sepsis, cardiac index drops left ventricular dilatation, and reduced left ventricular ejection force occur due to myocardial depression. Although ventricular depression is common in sepsis, its causes are poorly characterized. Troponin l, troponin T, and Pro Bnp are examples of biomarkers that can be used to identify myocardial damage. Myocardial damage can be diagnosed with increasing sensitivity and specificity thanks to cardiac troponins, which allow for early risk assessment.
Objective: This work aim ed to decrease morbidities and mortalities of septic patients and to assess the validity (accuracy) of serum troponin I in the detection of left ventricular dysfunction in septic patients.
Patients and Methods: A total of 30 patients were enrolled in a prospective study. They were hospitalized with a diagnosis of sepsis with normal cardiac functions before admission and then they were admitted to the Intensive Care Units Department Maadi Medical Complex during the period from 2018 to 2019.
Results: Non survived subjects had statistically significant higher SOFA score (10.25 1.39 vs. 8.95 0.72), higher APACHE II score (23.25 3.01 vs. 20.55 2.77), higher Physiology Score (16.75 2.71 vs. 12.23 3.82), longer duration of MV (8 1.69 vs5.83 1.72) and longer ICU stay (10.63 2.00 vs. 7.91 3.08) than survived subjects T here was no statistically significant difference regarding age, sex, and source of sepsis. The heart rate, serum troponin at admission and on 3rd day )), WBCs, serum Na, K, and serum Procalcitonin level were statistically significantly higher in non survived than in survived subjects. In contrast, LVEF% at admission and on 3rd day was
statistically significantly lower in non survived than in survived subjects .
Conclusion: We discovered a statistically significant difference when comparing those with and without LV dysfunction . In addition, a blood troponin level of > 1.17 on the third day had a sensitivity of 94.1% and a specificity of 92.3% for predicting LV dysfunction. To sum up, troponin is the best marker for identifying left ventricular dysfunction patients with sepsis.