scholarly journals Diagnostic Value of High-Sensitivity Troponin T for Subclinical Left Ventricular Systolic Dysfunction in Patients with Sepsis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Pham Dang Hai ◽  
Nguyen Thanh Binh ◽  
Nguyen Hong Tot ◽  
Ha Manh Hung ◽  
Le Thi Viet Hoa ◽  
...  
Keyword(s):  
Troponin T ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Ventricular Systolic Dysfunction ◽  
Ctnt Level

Background. Left ventricular systolic dysfunction (LVSD) is common in sepsis. Speckle-tracking echocardiography (STE) is a useful emerging tool for evaluating the intrinsic left ventricular systolic function. High-sensitivity cardiac troponin T (hs-cTnT) is the most sensitive biomarker of myocardial injury. However, there are limited data regarding the association between hs-cTnT level and left ventricular systolic dysfunction based on STE in septic patients. We performed this prospective study to evaluate the diagnostic value of hs-cTnT level for subclinical left ventricular systolic dysfunction measured by STE in septic patients according to the sepsis-3 definition. Methods. Patients with sepsis based on sepsis-3 definition admitted to the intensive care unit were prospectively performed STE and hs-cTnT level within 24 hours after the onset of sepsis. Baseline clinical and echocardiographic variables were collected. Left ventricular systolic dysfunction was defined as a global longitudinal strain of   ≥−15%. Results. During a 19-month period, 116 patients were enrolled in the study. The elevated hs-cTnT level was seen in 86.2% of septic patients, and 43.1% of patients had LVSD on STE. The median hs-cTnT level and the proportion of elevated hs-cTnT level (>14 ng/L) were significantly higher in patients with LVSD than in patients without LVSD. The area under the ROC curves of hs-cTnT to detect LVSD was 0.73 ( P  < 0.001). In the multivariate analysis, hs-cTnT (HR, 1.002; 95% CI, 1.000 to 1.004; P  = 0.025) and septic shock (HR, 7.6; 95% CI, 2.25 to 25.76; P  = 0.001) were independent predictors of LVSD. Conclusion. Our study indicated that the serum hs-cTnT level might be a useful biomarker for detecting LVSD in septic patients.

scholarly journals P926 High prevalence of left ventricular systolic dysfunction assessed by speckle tracking in asymptomatic HIV patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Kapelios ◽  
M Bonou ◽  
D Basoulis ◽  
C Masoura ◽  
E Athanasiadi ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Troponin T ◽  
Left Ventricular Systolic Dysfunction ◽  
Myocardial Dysfunction ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
People Living With Hiv ◽  
Ventricular Systolic Dysfunction ◽  
History Of

Abstract Background Cardiomyopathy presenting in people living with HIV (PLWHIV) has been attributed to the effect of inflammation, opportunistic infections, myocyte invasion and cardiac steatosis, while peripheral artery disease (PAD) is linked to immune activation, abnormalities in lipid metabolism, and traditional risk factors. The diagnosis of subclinical myocardial dysfunction and PAD could enable prompt implementation of therapeutic measures. However, data available to date on the specific topic are limited. Μethods:We investigated the association between global longitudinal strain (GLS) and a) patient history, b) baseline characteristics, c) carotid intima-media thickness (IMT) and presence of carotid atheromatic plaque(s) d) temperature difference (ΔT) along each carotid artery, measured by microwave radiometry (MWR) and e) basic blood panel measurements, including high-sensitivity troponin-T(hsTnT) and NT-proBNP in PLWHIV and no history of cardiovascular disease. Results We prospectively enrolled forty asymptomatic PLWHIV on long-term highly active antiretroviral therapy. Thirty-seven (93%) were men, while mean age was 52 ± 13 years. Subclinical left ventricular systolic dysfunction(SLVSD), defined as a value of GLS&gt; -18.7%, was present in 35% of patients. GLS value was significantly associated with age (r = 0.410,P = 0.013), history of hyperlipidemia (r = 0.370,P = 0.026), body mass index (r = 0.462,P = 0.005), waist circumference (r = 0.471,P = 0.007) and right bulb IMT (r = 0.390,P = 0.036). hs-TnT levels were significantly associated with age (r = 0.513, P = 0.001), CD4 count (r=-0.357,P = 0.025), serum creatinine (r = 0.338,P = 0.035) and the presence of carotid plaque (r = 0.374,P = 0.038). NT-proBNP levels were significantly associated with history of diabetes (r = 0.336,P = 0.048) and serum creatinine (r = 0.548,P = 0.001). No significant associations were demonstrated between carotid ΔΤ and other parameters. Conclusion Our results indicate that apart from age, a dysmetabolic component, expressed by higher BMI and history of hyperlipidemia, may be implicated in the pathogenesis of SLVSD, which may lead to cardiomyopathy, in PLWHIV.

scholarly journals Electrocardiography and Chest X-ray in Prediction of Left Ventricular Systolic Dysfunction

KYAMC Journal ◽  
2013 ◽  
Vol 2 (1) ◽  
pp. 118-122
Author(s):  
Md Nure Alom Siddiqui ◽  
Shahnaj Sultana ◽  
Abul Hossain ◽  
Muhammad Afsar Siddiqui
Keyword(s):  
Primary Care ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Systolic Dysfunction ◽  
X Ray ◽  
Chest X Ray ◽  
Trained Manpower

Introduction: Echocardiography is the definitive diagnostic tool for left ventricular systolic dysfunction. But it is expensive and requires trained manpower and thus might not be available in the primary care set up. EGG and Chest X ray, the more basic investigations, may help diagnose LVSD or at least streamline those who absolutely require echocardiography in primary care setup. Methods: ECG, Chest X ray and Echocardiography along with clinical assessment were performed on 70 patients with some form of complaints related to heart. The inferences on systolic function obtained from ECG, Chest X ray were compared with Echocardiography findings. Results: Out of 70 participants, 50 had left ventricular ejection fraction less than 45%, 56 had abnormal EGG, 60 had cardiomegaly in chest X-ray. A set of pre-selected ECG abnormalities had a sensitivity of 100% (83.4-100), specificity of 70% (35.4-91.9) and a positive predictive value of 89.3% (70.6-97.2) in diagnosing LVSD. Likewise, the figures were 92% (72.5-98.6), 30% (8.l-64.6) and 76.7% (57.3-89.4) respectively for a cardiothoracic ratio of more than 0.5 in chest X-ray. Conclusions: Although, ECG and Chest X-ray could not replace Echocardiography, they could very well give an idea of the systolic function of an individual and suggest the need or no need for an echo-study in primary care setup.DOI: http://dx.doi.org/10.3329/kyamcj.v2i1.13515 KYAMC Journal Vol.2(1) 2011 pp.118-122

scholarly journals Correlation of troponin-I level with left ventricular systolic dysfunction after first attack of non-ST segment elevation myocardial infarction

2019 ◽  
Vol 7 (5) ◽  
pp. 1392
Author(s):  
Mahmood H. Khan ◽  
Mirza Md. Nazrul Islam ◽  
Md. Shafiqul Islam ◽  
Kaisar Nasrullah Khan ◽  
Shamim Chowdhury ◽  
...  
Keyword(s):  
Heart Disease ◽  
Troponin I ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Specific Marker ◽  
Ventricular Systolic Dysfunction ◽  
Group I ◽  
Group Ii

Background: Coronary Heart Disease (CHD) is the most common category of the heart disease and is found to be the single most important cause that leads to premature death in the developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has shown itself as a very sensitive and specific marker for AMI. Ventricular function is the best predictor of death after an ACS. It serves as a marker of myocardial damage and provides information on systolic function as well as diagnosis and prognosis. The study aimed at investigating the impact of LVEF on elevated troponin-I level in patients with first attack of NSTEMI.Methods: This cross-sectional analytical study was conducted in the department of cardiology in Mymensingh Medical College Hospital from December, 2015 to November, 2016. Total 130 first attack of NSTEMI patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group-I: Patients with first attack of NSTEMI with LVEF: ≥55%. Group-II: Patients with first attack of NSTEMI with LVEF: <55%. Then LVEF and troponin-I levels were correlated using Pearson’s correlation coefficient test.Results: In this study mean troponin-I of group-I and group-II were 5.53±7.43 and 16.46±15.79ng/ml respectively. It was statistically significant (p<0.05). The mean LVEF value of groups were 65.31±10.30% and 40.17±4.62% respectively. It was statistically significant (p<0.05). The echocardiography showed that patients with high troponin-I level had low LVEF and patients with low troponin-I level had preserved LVEF. Analysis showed that patients with highest level of troponin-I had severe left ventricular systolic dysfunction (LVEF <35%) and vice versa-the patients with the lowest levels of troponin-I had preserved systolic function (LVEF ≥55%). In our study, it also showed that the levels of troponin-I had negative correlation with LVEF levels with medium strength of association (r= -0.5394, p=0.001). Our study also discovered that Troponin-I level ≥6.6ng/ml is a very sensitive and specific marker for LV systolic dysfunction.Conclusions: The study has enabled the research team to conclude that the higher is the Troponin-I level the lower is the LVEF level and thus more severe is the LV systolic dysfunction in first attack of NSTEMI patients.

P1812Speckle tracking echocardiography for early detection of left ventricular systolic dysfunction in patients with Chagas disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M C P Nunes ◽  
A L P Ribeiro ◽  
O R S Junior ◽  
C D L Olivera ◽  
C S Cardoso ◽  
...  
Keyword(s):  
Early Detection ◽  
Chagas Disease ◽  
Longitudinal Strain ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Lv Dysfunction

Abstract Introduction Longitudinal strain by speckle tracking echocardiography (STE) imaging is a reliable tool for quantitative measurement of myocardial contractility. Assessment of left ventricular (LV) systolic function has a central role in the evaluation of patients with Chagas disease, particularly for identification of subtle changes that could predict disease progression. Purpose We aimed to detect early LV dysfunction using LV global longitudinal strain (GLS) in patients with Chagas disease and its relationship to other echocardiographic and laboratory parameters. Methods Eight-hundred and fifty patients with Chagas disease (mean age of 60±12 years, 70% female) who live in remote areas in Brazil were enrolled. Clinical evaluation, ECG, N-terminal pro-brain natriuretic peptide (NT-ProBNP), and echocardiogram were performed. LV GLS was assessed offline on the four-, three- and two-chamber views. Patients were divided into tertiles according to the LV strain. Data were analyzed using One-way ANOVA. Results The ECG was normal in 19%, whereas typical ECG abnormalities related to Chagas cardiomyopathy were found in 58% of the patients. Overall mean LV ejection fraction (LVEF) was 59±11%, and LV GLS was - 14.1±4.4%. Apical aneurysm was detected in 34 patients (4%).The prevalence of LV systolic dysfunction, defined as LVEF <54% and GLS ≤ |16|%, was 19% and 66%, respectively. Abnormal GLS was observed in 408 (48%) patients despite a normal LVEF. Stratified according to tertiles of LV GLS, patients in the first tertile (strain <|10.7|%), had a significantly decreased in LVEF (Fig 1, A), increased E/e' ratio (Fig 2,B), left atrial volume (Fig 1,C), and NT-proBNP levels (Fig 1,D), indicating severity of LV dysfunction (n=215). Similarly, the patients in the third tertile (strain >|17|%), had normal standard echo parameters and NT-proBNP levels (n=210). However, patients in the second tertile (|10.7|% to |17|%; n=425), the strain was abnormal while other parameters were normal, showing LV impairment that was not evidenced by conventional exams. Conclusions LV longitudinal strain assessed by STE in a general population of Chagas disease provided diagnostic information beyond conventionally measured LVEF. Early detection of ventricular impairment may help to identify Chagas disease patients at risk for development of heart failure.

scholarly journals Association of Myeloid Cells of Triggering Receptor-1 with Left Ventricular Systolic Dysfunction in BALB/c Mice with Sepsis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Gaosheng Zhou ◽  
Lijun Ye ◽  
Liang Zhang ◽  
Liangqing Zhang ◽  
Yuanli Zhang ◽  
...  
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Myocardial Damage ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Control Group ◽  
Ventricular Systolic Dysfunction ◽  
Lps Challenge ◽  
And Control

Objective. To investigate the correlation between TREM-1 and LPS-induced left ventricular systolic dysfunction in BALB/c mice.Methods. Male BALB/c mice were randomly divided into 3 groups: LPS, LPS/TREM-1, and control groups which were injected intraperitoneally with 25 mg/kg LPS, 5 μg TREM-1mAb 1 h after LPS challenge, and sterilized normal saline, respectively. Left ventricular systolic function was monitored by echocardiography at 6 h, 12 h, and 24 h. Meanwhile, TNF-α, IL-1β, and sTREM-1 in serum and myocardium were determined by ELISA or real-time PCR; at last left ventricles were taken for light microscopy examination.Results. FS and EF in LPS/mAbTREM-1 group, significantly declined compared with LPS and control group at 12 h, were accompanied with a markedly increase in serum IL-1β(at 6 h) and sTREM-1 (at 12 h and 24 h) expression. Myocardium TNF-α(at 6 h and 24 h) and sTREM-1 (at 6 h) were significantly higher in LPS/mAbTrem-1-treated mice than in time-matched LPS-treated mice; meanwhile myocardium TNF-αmRNA were markedly increased in comparison with LPS-treated or saline-treated mice at 24 h. Besides, mAbTREM-1 aggravated LPS-induced myocardial damage was observed.Conclusions. Our results suggest that TREM-1 is significantly associated with LPS-induced left ventricular systolic dysfunction in BALB/c mice.

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