The Role Of Bnp Joint Myocardial Injury Markers In The Prognosis Evaluation Of Severe Sepsis In Patients With Myocardial Injury

Introduction:septic patients has a high mortality.The importance of cardiomyocyte damage during sepsis has been a recent subject of interest. The present study was designed to test if Combination of Cardiac Troponin I and B-Type Natriuretic Peptide allows for identifica-tion of patients at risk for developing sepsis-induced myocardial depression and if an increased concentration of BNP is associatedwith an adverse outcome in patients with septic shock. Methods and Results:In a prospective study,66 patients with septic shock were divided into one group with normal ventricular function (left ventricular ejection fraction>50%) on days 3 to 5and another group of patients with impaired left ven-tricular function (left ventricular ejection fraction<50%) on days3to5, TnI,BNP and LVEF was measured at baseline and at days 3,5, and 12,respectively and proceeded T-test and multiple factor correlation analysis. Patients with impaired left ventricular function had an increased median plasma BNP concentration on day 3,5 and an ejection fraction of on day 3,5 vs. in patients without impaired left ventricular function. There was a close negative relation between increased plasma TNI concentrations and depressed left ventricular ejection fraction.In addition, the survival was considered as a variable indicating whether a patient had survived up to day 30 or not, as 30 days is the usual follow-up time. Patients having survived up to day 30 are compared with patients who died during the follow-up period. TnI,BNP and LVEF was measured at baseline and at days 3,5,and 12, respectively and proceeded T-test and multiple factor correlation analysis with APACHE II and survival rate. In an additional receiver operating characteristic curve analysis, the predictive value of a model including cardiovascular risk factors and additional BNP concentration on day 5, compared with a baseline model of cardiovascular risk factors, improved the area under the curve the most; therefore, this model was suited best for prediction of sepsis-induced myocardial depression and 30-day survival for patients with septic shock. There was a close positive relation between increased plasma TNI concentrations and APACHE II and a close negative relation between increased plasma TNI concentrations and survival rate in 0,3-5 day.but There was not a close relation between increased plasma TNI concentrations and APACHE II and a close negative relation between increased plasma TNI concentrations and survival rate in 12 day. There was statistical significance between increased plasma TNI concentrations and survival rate of 30 day in 12 dayConclusion:These results indicate that plasma BNP and TNI concentration represents a reliable marker for identification of patients developing sepsis-induced myocardial depression. There was a close relation between increased plasma TNI concentrations and depressed left ventricular ejection fraction.increased plasma TNI concentrations can more reflect heart function than increased plasma BNP concentrations. In addition,BNP and TNI concentration may be used as a prognostic marker to identify patients with an elevated risk for an adverse outcome. TNI concentration of the prophase and BNP concentration on day 5 is especially important to identify patients with an elevated risk for an adverse outcome. Combination of Cardiac Troponin I and B-Type Natriuretic Peptide can allows for identification of patients at risk for developing sepsis-induced myocardial depression and the Prognosis their patients with septic shock and severity sepsis.