The diagnostic value of admission myoglobin for sepsis-induced cardiomyopathy: a prospective cohort study
- 1Department of Emergency, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
- 2Fujian Key Laboratory of Vascular Aging, Fujian Medical University, Fuzhou, China
Abstract
Background: Sepsis-induced cardiomyopathy (SICM) is a frequent and under-recognized complication of sepsis. Early diagnosis remains challenging. We evaluated the diagnostic value of admission myoglobin (MYO), alone and combined with NT-proBNP and the SOFA score, for SICM in patients with sepsis.
Methods: In this single-center prospective cohort study (April 2022 to May 2024), we enrolled 158 patients with sepsis diagnosed according to Sepsis-3 criteria. Blood samples for MYO and NT-proBNP were collected within 24 h of admission; admission echocardiography was performed as soon as feasible (within 24 h whenever possible, and within 72 h in all enrolled patients); follow-up echocardiography was performed between day 7 and day 14. SICM was defined as left ventricular ejection fraction (LVEF) below 50% with documented reversibility. Univariate and multivariate logistic regression analyses were performed to identify factors associated with SICM, adjusting for age, sex, body mass index, and renal function. Receiver operating characteristic (ROC) curve analysis, internal validation by 1,000 bootstrap resamples, and decision curve analysis (DCA) were performed. Model calibration was assessed by a calibration plot, the calibration intercept and slope, and the Brier score, with bootstrap optimism-corrected estimates.
Results: Of 158 patients, 63 (39.9%) were diagnosed with SICM. MYO levels were significantly higher in the SICM group than in the non-SICM group (median 395.7 vs. 97.3 ng/mL, P < 0.001). In multivariate analysis adjusting for age, sex, BMI, and renal function, MYO (OR 1.061 per 100 ng/mL, 95% CI 1.008–1.115; P = 0.023) and NT-proBNP (OR 1.087 per 1,000 pg/mL, 95% CI 1.025–1.153; P = 0.005) were independently associated with SICM. The combined model (MYO + NT-proBNP + SOFA) achieved an area under the ROC curve (AUC) of 0.821 (95% CI: 0.750–0.892), outperforming SOFA alone (AUC 0.743; likelihood ratio test P < 0.001); the optimism-corrected AUC after bootstrap validation was 0.812. The model was well calibrated (calibration intercept 0.00, slope 1.00; Brier score 0.173). DCA suggested potential net benefit across threshold probabilities of 0.1–0.7.
Conclusion: Admission MYO, particularly in combination with NT-proBNP and SOFA, may assist in the early identification and diagnosis of SICM.
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BibTeX
@article{chen2026diagnostic,
title = {{The diagnostic value of admission myoglobin for sepsis-induced cardiomyopathy: a prospective cohort study}},
author = {Yue Chen and Xiaohong Lin and Guangwei Yu},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1921535},
url = {https://doi.org/10.3389/fcvm.2026.1921535},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The diagnostic value of admission myoglobin for sepsis-induced cardiomyopathy: a prospective cohort study
AU - Yue Chen
AU - Xiaohong Lin
AU - Guangwei Yu
PY - 2026
DA - 2026/10/12
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1921535
UR - https://doi.org/10.3389/fcvm.2026.1921535
AB - Background: Sepsis-induced cardiomyopathy (SICM) is a frequent and under-recognized complication of sepsis. Early diagnosis remains challenging. We evaluated the diagnostic value of admission myoglobin (MYO), alone and combined with NT-proBNP and the SOFA score, for SICM in patients with sepsis. Methods: In this single-center prospective cohort study (April 2022 to May 2024), we enrolled 158 patients with sepsis diagnosed according to Sepsis-3 criteria. Blood samples for MYO and NT-proBNP were collected within 24 h of admission; admission echocardiography was performed as soon as feasible (within 24 h whenever possible, and within 72 h in all enrolled patients); follow-up echocardiography was performed between day 7 and day 14. SICM was defined as left ventricular ejection fraction (LVEF) below 50% with documented reversibility. Univariate and multivariate logistic regression analyses were performed to identify factors associated with SICM, adjusting for age, sex, body mass index, and renal function. Receiver operating characteristic (ROC) curve analysis, internal validation by 1,000 bootstrap resamples, and decision curve analysis (DCA) were performed. Model calibration was assessed by a calibration plot, the calibration intercept and slope, and the Brier score, with bootstrap optimism-corrected estimates. Results: Of 158 patients, 63 (39.9%) were diagnosed with SICM. MYO levels were significantly higher in the SICM group than in the non-SICM group (median 395.7 vs. 97.3 ng/mL, P < 0.001). In multivariate analysis adjusting for age, sex, BMI, and renal function, MYO (OR 1.061 per 100 ng/mL, 95% CI 1.008–1.115; P = 0.023) and NT-proBNP (OR 1.087 per 1,000 pg/mL, 95% CI 1.025–1.153; P = 0.005) were independently associated with SICM. The combined model (MYO + NT-proBNP + SOFA) achieved an area under the ROC curve (AUC) of 0.821 (95% CI: 0.750–0.892), outperforming SOFA alone (AUC 0.743; likelihood ratio test P < 0.001); the optimism-corrected AUC after bootstrap validation was 0.812. The model was well calibrated (calibration intercept 0.00, slope 1.00; Brier score 0.173). DCA suggested potential net benefit across threshold probabilities of 0.1–0.7. Conclusion: Admission MYO, particularly in combination with NT-proBNP and SOFA, may assist in the early identification and diagnosis of SICM.
SN - 2297-055X
ER -