Study of sepsis-induced myocardial dysfunction and its correlation with SOFA score and Creatine kinase-MB

Abstract

Background: Incidence of Sepsis-Induced Myocardial Dysfunction (SIMD) is reported at 18% to 65%, and the mortality rate is 40% to 70%. Few studies have explored the role of Creatine kinase-MB (CK-MB) as a biomarker for SIMD. Previous studies have proved that levels of cardiac biomarkers were higher in non-survivors.Aims and objectives:To study the frequency and spectrum of myocardial dysfunction in patients with sepsis by transthoracic echocardiography and evaluate the association between CK-MB and Sequential Organ Failure Assessment (SOFA) score.Materials and Methods:One hundred patients aged>18 years satisfying the sepsis definition with SOFA score ≥2 were studied at the Department of General Medicine and Cardiology on an in-patient basis. The cohort was grouped into SOFA score <5, between 5 and 7, and > 7.Clinical evaluation, assessment of complete blood counts, liver and renal function tests, serum electrolytes, arterial blood gas analysis, and 12-lead electrocardiography was performed. All patients were also subjected to two-dimensional transthoracic echocardiography.Results:The majority of the patients had a SOFA score <5 (53%), 30 had a SOFA score between 5-7, and 17 had a SOFA score >7. Out of 17 patients who had SOFA score >7, all had elevated CK-MB, similarly out of 30 patients who had SOFA score between 5-7; the majority had elevated CK-MB (86.7%) (P<0.001). Out of 17 patients who had SOFA score >7, all of them had an abnormal myocardial function; out of 30 patients who had SOFA score between 5-7, the majority had abnormal myocardial function (80%) (P<0.001).Conclusion:SOFA score and CK-MB are vital tools for assessing myocardial dysfunction in patients suffering from sepsis. Early detection can reduce the risk of mortality.