Dynamics of myocardial damage markers in patients with infective endocarditis complicated by acute heart failure

Patients with Infective Endocarditis (IE) complicated by Acute Heart Failure (AHF) require immediate cardiac surgery. Detection of high levels of N-terminal B-type natriuretic propeptide (NT-proBNP) and Cardiac Troponin I (cTnI) may facilitate early recognition of such patients. The aim of the study was to determine the dynamics of markers of myocardial injury in 75 patients with IE hospitalised at the Amosov National Institute of Cardiovascular Surgery in the period from 2019 to 2023. The diagnosis of IE was made according to the Duke criteria, and all patients were classified as class IV according to the New York Heart Association (NYHA) functional classification. The examination data are shown in the form (Me[Q1;Q3]). For an in-depth study of myocardial damage in heart failure, the levels of NT-proBNP and cTnI were analysed at five stages: at the beginning of surgery, after completion of cardiopulmonary bypass, on days2, 7, and 14 of the postoperative period. In patients with HF, preoperative NT-proBNP levels were NT-proBNP – 8110.0 (2091.4;17738.3) pg/ml; and cTnI – 0.2 (0.1;0.74) ng/ml. After the operation, NT-proBNP and cTnI levels increased to 8778.6 pg/mL (3798.0;15674.9) and 4.83 ng/mL (2.36;9.61), respectively. The median duration of artificial lung ventilation was 21 hours (14;29). According to the results of the data analysis, patients with a duration of artificial lung ventilation (ALV) of 29 hours were included in the third quartile. The total duration of inpatient treatment was 19 days, and the ICU stay for patients with IE complicated by AHF was 7 (5;11) days. The total duration of inpatient treatment was 19 (14;22) days. The results showed an increase in cTnI level with a simultaneous decrease in NT-proBNP after surgery, followed by a steady increase in both markers in patients with IE complicated by AHF. Keywords: cardiac dysfunction, dynamics of biomarker levels, cardiovascular damage, cardiac surgery, perioperative period.