ASSESSMENT OF SEPSIS INDUCED CARDIAC DYSFUNCTION IN NEONATAL SEPSIS BY SPECKLE TRACKING ECHOCARDIOGRAM AND TISSUE DOPPLER AND CORRELATION WITH SERUM CARDIAC TROPONIN -T AND PROCALCITONIN

Abstract

Aim: The aim of this work was assessment of sepsis induced cardiac dysfunction( SIMD) in neonates with sepsis by 2-dimensional speckle tracking echocardiography, tissue Doppler as well as other conventional echocardiographic methods and its correlation with serum procalcitonin (PCT) and, cardiac troponin –T( cTnT). Methods: This study was prospective controlled cohort study that included 60 neonates with diagnosis of neonatal sepsis compared to 60 healthy newborns who were matching in age and sex. both groups was subjected to basic and advanced transthoracic echocardiography and some lab markers in order to assess sepsis induced cardiac
dysfunction, and correlates the findings with serum procalcitonin, cardiac troponin –T.
Results: Out of the enrolled 60 patients and 60 controls. Mean age of cases was 16.62±4.74 days and 14.85±5.88 days for controls. blood culture was positive in 48.3%; 65.5% was gram positive and 34.4 % was gram negative, Median Procalcitonin among cases was 5.20 ng/ml compared to 0.22 among controls, median cTnT among cases was 0.27 compared to 0.03 among controls, LVGLS was -10.79±1.47 among cases vs -14.68±1.13 among controls, P value <0.001. mean EF was 46.03±6.93 among cases versus 62.58±5.69 among controls, P value <0.001, There was significant positive correlation between left ventricular global longitudinal strain (LV GLS) and PCT and cTnT
levels .

Conclusion. PCT is good markers of neonatal sepsis . cTnT is a good laboratory indicator for cardiac affection in neonatal sepsis. speckle tracking echocardiography is a promising tool in assessment of cardiac function PCT and cTnT were correlated with both LV and RV systolic dysfunction detected by tissue Doppler imaging(TDI) and STE ,SIMD is very common comorbidity in neonatal sepsis,