High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive care

<p>Abstract</p> <p>Background</p> <p>Left ventricular (LV) dysfunction is well documented in the critically ill. We assessed 1-year mortality in relation to cardiac biomarkers and LV function parameters by echocardiography in patients with shock.</p> <p>Meth...

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Main Authors: Bergenzaun Lill, Öhlin Hans, Gudmundsson Petri, Düring Joachim, Willenheimer Ronnie, Chew Michelle S
Format: Article
Language:English
Published: BMC 2012-09-01
Series:BMC Anesthesiology
Subjects:
Online Access:http://www.biomedcentral.com/1471-2253/12/25
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author Bergenzaun Lill
Öhlin Hans
Gudmundsson Petri
Düring Joachim
Willenheimer Ronnie
Chew Michelle S
author_facet Bergenzaun Lill
Öhlin Hans
Gudmundsson Petri
Düring Joachim
Willenheimer Ronnie
Chew Michelle S
author_sort Bergenzaun Lill
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Left ventricular (LV) dysfunction is well documented in the critically ill. We assessed 1-year mortality in relation to cardiac biomarkers and LV function parameters by echocardiography in patients with shock.</p> <p>Methods</p> <p>A prospective, observational, cohort study of 49 patients. B-natriuretic peptide (BNP), high-sensitive troponin T (hsTNT) and transthoracic echocardiography (TTE) were assessed within 12 h of study inclusion. LV systolic function was measured by ejection fraction (LVEF), mean atrioventricular plane displacement (AVPDm), peak systolic tissue Doppler velocity imaging (TDIs) and velocity time integral in the LV outflow tract (LVOT VTI). LV diastolic function was evaluated by transmitral pulsed Doppler (E, A, E/A, E-deceleration time), tissue Doppler indices (é, á, E/é) and left atrial volume (La volume). APACHE II (Acute Physiology and Chronic Health Evaluation) and SOFA (Sequential Organ Failure Assessment) scores were calculated.</p> <p>Results</p> <p>hsTNT was significantly higher in non-survivors than in survivors (60 [17.0-99.5] vs 168 [89.8-358] ng/l, p = 0.003). Other univariate predictors of mortality were APACHE II (p = 0.009), E/é (p = 0.023), SOFA (p = 0.024) and age (p = 0.031). Survivors and non-survivors did not differ regarding BNP (p = 0.26) or any LV systolic function parameter (LVEF p = 0.87, AVPDm p = 0.087, TDIs p = 0.93, LVOT VTI p = 0.18). Multivariable logistic regression analysis identified hsTNT (p = 0.010) as the only independent predictor of 1-year mortality; adjusted odds ratio 2.0 (95% CI 1.2- 3.5).</p> <p>Conclusions</p> <p>hsTNT was the only independent predictor of 1-year mortality in patients with shock. Neither BNP nor echocardiographic parameters had an independent prognostic value. Further studies are needed to establish the clinical significance of elevated hsTNT in patients in shock.</p>
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spelling doaj.art-4f111e3a345545ea970a7a56a54002932022-12-21T22:11:02ZengBMCBMC Anesthesiology1471-22532012-09-011212510.1186/1471-2253-12-25High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive careBergenzaun LillÖhlin HansGudmundsson PetriDüring JoachimWillenheimer RonnieChew Michelle S<p>Abstract</p> <p>Background</p> <p>Left ventricular (LV) dysfunction is well documented in the critically ill. We assessed 1-year mortality in relation to cardiac biomarkers and LV function parameters by echocardiography in patients with shock.</p> <p>Methods</p> <p>A prospective, observational, cohort study of 49 patients. B-natriuretic peptide (BNP), high-sensitive troponin T (hsTNT) and transthoracic echocardiography (TTE) were assessed within 12 h of study inclusion. LV systolic function was measured by ejection fraction (LVEF), mean atrioventricular plane displacement (AVPDm), peak systolic tissue Doppler velocity imaging (TDIs) and velocity time integral in the LV outflow tract (LVOT VTI). LV diastolic function was evaluated by transmitral pulsed Doppler (E, A, E/A, E-deceleration time), tissue Doppler indices (é, á, E/é) and left atrial volume (La volume). APACHE II (Acute Physiology and Chronic Health Evaluation) and SOFA (Sequential Organ Failure Assessment) scores were calculated.</p> <p>Results</p> <p>hsTNT was significantly higher in non-survivors than in survivors (60 [17.0-99.5] vs 168 [89.8-358] ng/l, p = 0.003). Other univariate predictors of mortality were APACHE II (p = 0.009), E/é (p = 0.023), SOFA (p = 0.024) and age (p = 0.031). Survivors and non-survivors did not differ regarding BNP (p = 0.26) or any LV systolic function parameter (LVEF p = 0.87, AVPDm p = 0.087, TDIs p = 0.93, LVOT VTI p = 0.18). Multivariable logistic regression analysis identified hsTNT (p = 0.010) as the only independent predictor of 1-year mortality; adjusted odds ratio 2.0 (95% CI 1.2- 3.5).</p> <p>Conclusions</p> <p>hsTNT was the only independent predictor of 1-year mortality in patients with shock. Neither BNP nor echocardiographic parameters had an independent prognostic value. Further studies are needed to establish the clinical significance of elevated hsTNT in patients in shock.</p>http://www.biomedcentral.com/1471-2253/12/25EchocardiographyBNPHigh-sensitive TNTMyocardial functionMortalityShock
spellingShingle Bergenzaun Lill
Öhlin Hans
Gudmundsson Petri
Düring Joachim
Willenheimer Ronnie
Chew Michelle S
High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive care
BMC Anesthesiology
Echocardiography
BNP
High-sensitive TNT
Myocardial function
Mortality
Shock
title High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive care
title_full High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive care
title_fullStr High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive care
title_full_unstemmed High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive care
title_short High-sensitive cardiac Troponin T is superior to echocardiography in predicting 1-year mortality in patients with SIRS and shock in intensive care
title_sort high sensitive cardiac troponin t is superior to echocardiography in predicting 1 year mortality in patients with sirs and shock in intensive care
topic Echocardiography
BNP
High-sensitive TNT
Myocardial function
Mortality
Shock
url http://www.biomedcentral.com/1471-2253/12/25
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