N-Terminal B Natriuretic Peptide as a Prognostic Marker in Sepsis Induced Myocardial Dysfunction

Ahmed  Kamal; Dalia Ragab; Rasha M. Abdel  Samie; Mina Rafeek; Mohamed Al Desoky

doi:10.3889/oamjms.2022.10404

Authors

Ahmed Kamal Cairo University
Dalia Ragab Cairo University
Rasha M. Abdel Samie Cairo University
Mina Rafeek National Heart Institute, Cairo, Egypt
Mohamed Al Desoky Cairo University

DOI:

https://doi.org/10.3889/oamjms.2022.10404

Keywords:

Sepsis, Sepsis induced myocardial dysfunction, N terminal pro-BNP, Predictor, Mortality, Septic shock

Abstract

BACKGROUND: Sepsis-induced myocardial dysfunction (SIMD) is an increasingly recognized form of transient cardiac dysfunction in sepsis patients.

AIM: The aim of the study was to evaluation of N-terminal pro brain natriuretic peptide (NT-pro BNP) as a predictor of SIMD and poor outcome in patients with sepsis or septic shock.

METHODS: Forty patients were enrolled and divided into: Group 1 with sepsis; Group 2 with septic shock. Each group was subdivided according to the presence or absence of cardiomyopathy. Echocardiography, NT-pro BNP - assay on the 1st and 2nd days of admission - were performed.

RESULTS: NT-pro BNP level was significant predictor for cardiomyopathy in all case group with 75% sensitivity, 70% specificity (cutoff level >334 pg/ml) on 1st day of admission and 65% sensitivity, and 80% specificity (cutoff level >325 pg/ml) on 2nd day. On subgroup analysis, pro-BNP had 70% sensitivity, 90% specificity; cutoff level >334 pg/ml for prediction of cardiomyopathy in sepsis group and 70% sensitivity and 80% specificity; cutoff level >357pg/ml in septic shock group. Pro-BNP on 2nd day was excellent predictor of mortality in septic shock group with 100% sensitivity and specificity; cutoff level >350 pg/ml.

CONCLUSION: N terminal pro-BNP is a good diagnostic and prognostic indicator for cardiomyopathy and mortality in septic patients.

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