Yu Jiamin, Chen Yongxia, Pan Xiaoyan, Chen Ji, Mai Zhenhua, Zhang Yuanli, Wang Xiaoyan, Zhou Gaosheng, Bukhari Sayed Adam, Ma Daqing, Deng Liehua
Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524000, People's Republic of China.
Doctoral Scientific Research Center, Lianjiang People's Hospital, Zhanjiang, 524400, People's Republic of China.
J Inflamm Res. 2024 Oct 29;17:7869-7879. doi: 10.2147/JIR.S481792. eCollection 2024.
The early diagnosis of septic cardiomyopathy remains a challenge. The present work aims to evaluate the diagnostic and prognostic value of plasma soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) levels in septic cardiomyopathy when compared with traditional myocardial biomarkers.
In the 143 sepsis enrolled patients, 67 and 76 patients were classified as non-septic cardiomyopathy and septic cardiomyopathy, respectively. Their blood samples were harvested up to 14th day after hospital admission for measurements of sTREM-1 and other biomarkers, such as N-terminal pronatriuretic peptide (NT-proBNP), highly sensitive troponin (TNT-HS), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), etc. All the data were collected at 8:00 a.m. The area under the receiver operating characteristic curve was obtained to assess the diagnostic accuracy of those biomarkers. The Log rank test was utilized to evaluate the prognostic value of sTREM-1 on septic cardiomyopathy.
Circulating sTREM-1 showed a high specificity (88.1%) and moderate sensitivity (64.5%) to distinguish patients with septic cardiomyopathy in the 143 septic patients. The diagnostic efficiency of sTREM-1 was higher than inflammatory biomarkers and traditional myocardial markers. Logistic regression revealed that plasma sTREM-1 was an independent predictor of septic cardiomyopathy. Furthermore, in the whole septic cardiomyopathy cohorts, the sTREM-1 levels in the non-survivors were significantly higher than those of survivors during ICU stay. In addition, the left ventricular systolic dysfunction had a high odds ratio (3.968) to predict 90-day mortality in septic patients with cardiomyopathy.
High plasma sTREM-1 level may be a diagnostic marker in predicting ICU poor outcome of patients with septic cardiomyopathy.
脓毒症性心肌病的早期诊断仍然是一项挑战。本研究旨在评估与传统心肌生物标志物相比，血浆可溶性髓系细胞触发受体-1（sTREM-1）水平在脓毒症性心肌病中的诊断和预后价值。
在纳入的143例脓毒症患者中，67例和76例患者分别被分类为非脓毒症性心肌病和脓毒症性心肌病。在入院后第14天采集他们的血样，以测定sTREM-1和其他生物标志物，如N末端脑钠肽前体（NT-proBNP）、高敏肌钙蛋白（TNT-HS）、肌红蛋白（MYO）、肌酸激酶同工酶（CK-MB）等。所有数据均在上午8:00收集。获得受试者工作特征曲线下面积以评估这些生物标志物的诊断准确性。采用Log rank检验评估sTREM-1对脓毒症性心肌病的预后价值。
在143例脓毒症患者中，循环sTREM-1对区分脓毒症性心肌病患者具有较高的特异性（88.1%）和中等的敏感性（64.5%）。sTREM-1的诊断效率高于炎症生物标志物和传统心肌标志物。Logistic回归显示血浆sTREM-1是脓毒症性心肌病的独立预测因子。此外，在整个脓毒症性心肌病队列中，非幸存者在重症监护病房（ICU）住院期间的sTREM-1水平显著高于幸存者。此外，左心室收缩功能障碍在预测脓毒症性心肌病患者90天死亡率方面具有较高的优势比（3.968）。
血浆sTREM-1水平升高可能是预测脓毒症性心肌病患者ICU不良结局的诊断标志物。
