Effects of Hemoperfusion on Serum Cardiac Troponin T Concentrations Using Polymyxin B-Immobilized Fibers in Septic Patients Undergoing Hemodialysis

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Abstract
We investigated whether serum cardiac troponin T levels are altered in septic patients undergoing hemodialysis and whether polymyxin B-immobilized fiber (PMX-F) treatment affects these levels. Fourteen hemodialysis patients with sepsis, 14 hemodialysis patients without sepsis, and 12 age matched healthy controls were included in this study. Cardiac troponin T levels in hemodialysis patients with sepsis (0.56 ± 0.28 μg/L) were higher than levels in hemodialysis patients without sepsis (0.16 ± 0.06 μg/L, p < 0.01) and healthy control subjects (0.03 ± 0.01 μg/L, p < 0.001). The 14 hemodialysis patients with sepsis were randomly assigned to one of two treatment approaches: PMX-F treatment (n = 7) or conventional treatment (n = 7). Plasma endotoxin levels were significantly reduced from 46.6 ± 17.8 pg/ml to 8.2 ± 2.4 pg/ml, p < 0.01, in patients treated with PMX-F, and serum cardiac troponin T levels were also reduced from 0.62 ± 0.30 μg/L to 0.26 ± 0.12 μg/L, p < 0.05. Cardiac troponin T levels were unchanged in patients under conventional treatment. These data suggest that cardiac troponin T is indeed elevated in septic patients undergoing hemodialysis and may reflect subclinical myocardial cell damage. PMX-F is effective in reducing myocardial damage, in part, due to reducing plasma endotoxin levels.