The value of serum NT-proBNP and HBDH in the diagnosis of secondary cardiac dysfunction in elderly patients with sepsis

FAN Yan-qi; CHEN Jie; LU Guang-xuan; LIU Ru-ming; AN Shu-guang; JIA Bo-kang; YANG Shu-juan; ZHANG Jian-chang; LI Pan-shi

doi:10.13820/j.cnki.gdyx.20232768

Abstract：Objective To evaluate the value of N-terminal pro-brain natriuretic peptide(NT-proBNP)and hydroxybutyrate dehydrogenase(HBDH)in diagnosing secondary heart failure in elderly patients with sepsis.Methods A case-control study was conducted,with 80 elderly patients with sepsis from January 2020 to December 2021 as the study subjects.Patients were divided into a heart failure group(36 cases)and a non-heart failure group(44 cases)based on whether they had concurrent heart failure.The echocardiographic indicators,NT-proBNP,HBDH,and levels of inflammatory factors between the two groups were compared.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of echocardiographic indicators,NT-proBNP,and HBDH in sepsis with concur-rent heart failure.Results The left ventricular ejection fractions(LVEF),stroke volume variation(SVV),cardiac out-put(CO),fraction shortening(FS),and mitral early diastolic inflow velocity/mitral late diastolic inflow velocity(E/A)values of the heart failure group were significantly lower than those of the non-heart failure group,with statistically signif-icant differences(P＜0.05).The NT-proBNP,HBDH,interleukin(IL-6),tumor necrosis factor(TNF-α),pro-calcitonin(PCT)values,APACHE Ⅱ scores,and Sofa scores of the heart failure group were significantly higher than those of the non-heart failure group,with statistically significant differences(P＜0.05).There was no statistically sig-nificant difference in C-reactive protein(CRP)levels between the two groups(P＞0.05).For the 36 patients with sep-sis and concurrent heart function damage,the NT-proBNP values were negatively correlated with LVEF,SVV,CO,FS,and E/A(P＜0.05);and HBDH values were negatively correlated with LVEF and FS(P＜0.05).The sensitivities of NT-proBNP,HBDH,and NT-proBNP+HBDH in diagnosing sepsis with concurrent heart failure were 76.17％,48.52％,and 92.41％,respectively,and the specificities were 91.90％,89.20％,and 84.58％,respectively.The ar-ea under the ROC curve(AUC)were 0.893,0.757,and 0.944,respectively.Conclusion The diagnostic efficacy of NT-proBNP and HBDH alone for predicting heart failure in patients with sepsis is limited.The combined use of NT-proBNP and HBDH has high clinical value in diagnosing sepsis with concurrent heart failure and is significantly correlated with cardiac function indicators.In clinical practice,NT-proBNP and HBDH results may be considered in conjunction with ultrasound diagnosis to determine whether patients with sepsis have concurrent heart failure.