Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis
BACKGROUND Releasing cytokine pro inflammation in patients with sepsis (tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and IL-6) with other factors (mid regional pro atrial natriuretic peptide [MR-proANP] and TNF-α) will cause left ventricular systolic dysfunction (LVSD). This research...
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doaj-217a0c63894047aeb54848e55f77f4f42020-11-25T02:26:24ZengFaculty of Medicine Universitas Indonesia Medical Journal of Indonesia0853-17732252-80832019-08-0128210.13181/mji.v28i2.19521952Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsisTrisulo Wasyanto0Guntur Hermawan1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Dr. Moewardi Hospital, Surakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Dr. Moewardi Hospital, Surakarta, Indonesia BACKGROUND Releasing cytokine pro inflammation in patients with sepsis (tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and IL-6) with other factors (mid regional pro atrial natriuretic peptide [MR-proANP] and TNF-α) will cause left ventricular systolic dysfunction (LVSD). This research aimed to prove MR-proANP as a biomarker of LVSD in sepsis, area under the curve (AUC), sensitivity, specificity, cut-off point and probability of MR-proANP and TNF-α as a biomarker of LVSD. METHODS Non-experimental diagnostic test with cross sectional design and simple random sampling. Variable examined consisted of MR pro ANP, TNF-α and left ventricular ejection fraction (LVEF). LVSD if LVEF was ≤45%. Statistical analysis using 2 × 2 table and receiver operating characteristic curve using SPSS 22 for window. RESULTS There were examined 71 patients from November 2013 to March 2014 in tertiary ICU of Moewardi Hospital. There were 22 patients with mild sepsis (30.9%), 40 patients with severe sepsis (56.4%) and 9 patients with septic shock (12.7%). The AUC value of MR-proANP level was 0.84 (95% CI 0.73–0.95), p < 0.001. Optimal cut off point was ≥225.95 pmol/l and diagnostic odd ratio (DOR) was 12.11. The AUC value of TNF-α level was 0.73 (95% CI 0.60–0.86), p < 0.002. Optimal cut-off point was ≥7.36 pg/ml and DOR was 5.03. Multivariate analysis was resulted that MR-proANP was the best predictor of LVSD (AUC 0.78), and TNF-α (0.69). CONCLUSIONS MR-proANP could be used as a biomarker and the best diagnostic predictor of LVSD. http://mji.ui.ac.id/journal/index.php/mji/article/view/1952biomarkersleft ventricular dysfunctionatrial natriuretic peptidetumor necrosis factor-alpha |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Trisulo Wasyanto Guntur Hermawan |
spellingShingle |
Trisulo Wasyanto Guntur Hermawan Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis Medical Journal of Indonesia biomarkers left ventricular dysfunction atrial natriuretic peptide tumor necrosis factor-alpha |
author_facet |
Trisulo Wasyanto Guntur Hermawan |
author_sort |
Trisulo Wasyanto |
title |
Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis |
title_short |
Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis |
title_full |
Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis |
title_fullStr |
Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis |
title_full_unstemmed |
Mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis |
title_sort |
mid-regional pro-atrial natriuretic peptide as a biomarker of left ventricular systolic dysfunction in patients with sepsis |
publisher |
Faculty of Medicine Universitas Indonesia |
series |
Medical Journal of Indonesia |
issn |
0853-1773 2252-8083 |
publishDate |
2019-08-01 |
description |
BACKGROUND Releasing cytokine pro inflammation in patients with sepsis (tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β) and IL-6) with other factors (mid regional pro atrial natriuretic peptide [MR-proANP] and TNF-α) will cause left ventricular systolic dysfunction (LVSD). This research aimed to prove MR-proANP as a biomarker of LVSD in sepsis, area under the curve (AUC), sensitivity, specificity, cut-off point and probability of MR-proANP and TNF-α as a biomarker of LVSD.
METHODS Non-experimental diagnostic test with cross sectional design and simple random sampling. Variable examined consisted of MR pro ANP, TNF-α and left ventricular ejection fraction (LVEF). LVSD if LVEF was ≤45%. Statistical analysis using 2 × 2 table and receiver operating characteristic curve using SPSS 22 for window.
RESULTS There were examined 71 patients from November 2013 to March 2014 in tertiary ICU of Moewardi Hospital. There were 22 patients with mild sepsis (30.9%), 40 patients with severe sepsis (56.4%) and 9 patients with septic shock (12.7%). The AUC value of MR-proANP level was 0.84 (95% CI 0.73–0.95), p < 0.001. Optimal cut off point was ≥225.95 pmol/l and diagnostic odd ratio (DOR) was 12.11. The AUC value of TNF-α level was 0.73 (95% CI 0.60–0.86), p < 0.002. Optimal cut-off point was ≥7.36 pg/ml and DOR was 5.03. Multivariate analysis was resulted that MR-proANP was the best predictor of LVSD (AUC 0.78), and TNF-α (0.69).
CONCLUSIONS MR-proANP could be used as a biomarker and the best diagnostic predictor of LVSD.
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topic |
biomarkers left ventricular dysfunction atrial natriuretic peptide tumor necrosis factor-alpha |
url |
http://mji.ui.ac.id/journal/index.php/mji/article/view/1952 |
work_keys_str_mv |
AT trisulowasyanto midregionalproatrialnatriureticpeptideasabiomarkerofleftventricularsystolicdysfunctioninpatientswithsepsis AT gunturhermawan midregionalproatrialnatriureticpeptideasabiomarkerofleftventricularsystolicdysfunctioninpatientswithsepsis |
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