The Prognostic Value of Transthoracic Echocardiography and Biomarkers of Cardiac Dysfunction in Community-acquired Pneumonia.
Clin Microbiol Infect. 2016 Sep 3;
Authors: Biteker FS, Başaran Ö, Doğan V, Çaylak SD, Yıldırım B, Sözen H
BACKGROUND: The aim of this studywas to determine the prognostic role of echocardiography and compare with admission N-terminal proB-type natriuretic peptide (NT-proBNP) levels in adult patients with community-acquired pneumonia (CAP).
METHODS: Consecutive adult patients hospitalized with CAP were prospectively enrolled and followed-up until hospital discharge or death. Echocardiography was performed within the first 48 hours. Complicated hospitalization (CH) was defined as intensive care unit admission, need for mechanical ventilation or in-hospital mortality. This study was registered with ClinicalTrials.gov, number NCT02441855.
RESULTS: A total of 15 CH(13.5%) occurred among 111 patients with CAP. CAP patients with a CH compared to those without CH had significantly higher NT-proBNP values (1267.4±1146.1vs 305.6±545.7 pg/mL, p < 0.001) and troponin I (23.8±24.3 vs 10.3±6.3 ng/mL, p = 0.02) but had lower left ventricle ejection fraction (52.7±8.7 vs 60.5±6.7 %, p < 0.001) and tricuspid annular plane systolic excursion (TAPSE) which is a measure of right ventricular systolic function (17.1±4.4 vs. 21.8±4 mm; p= 0.001). Patients with elevation of NT-proBNP and decreased TAPSE at presentation had a significantly higher probability of CH (60%) than patients with either elevated NT-proBNP or decreased TAPSE (40%). Patients with neither elevated NT-proBNP nor decreased TAPSE had a 0% probality of CH.
CONCLUSION: This is the first study to demonstrate that decreased right ventricular systolic function is associated with increased rates of adverse events in patients with CAP.
PMID: 27596535 [PubMed - as supplied by publisher]