Prevalence and Correlation of Cardiac Manifestations in Dengue: A Study of Electrocardiographic, Echocardiographic, and Cardiac Marker Associations with Disease Severity (Code-T0032)

Introduction: Dengue fever is a life-threatening vector-borne tropical disease. The causative agent for dengue fever is Dengue virus (DENV). It is an acute febrile infectious disease. DENV-1, DENV-2, DENV-3, and DENV-4 are the four virus serotypes which are transmitted to humans mostly by the Aedes aegypti mosquito. Immunity to all the serotypes does not develop due to infection with any one serotype.

Aim and Objectives

Aim: To study the prevalence of cardiac manifestations in patients of dengue

Objectives:

• To find out the correlation of electrocardiographic findings with severity of dengue to find out the correlation of echocardiographic findings with severity of dengue to find out the correlation of cardiac marker like CK-MB with severity of dengue
• To find out the correlation of platelet count with prevalence of cardiac manifestations

Methods: A prospective observational study was conducted on 55 patients with AHRF admitted to a tertiary care hospital. Inclusion criteria encompassed patients aged 20-80 years with AHRF indicated for NIV. Exclusion criteria included hemodynamic instability, immediate need for intubation, and contraindications to NIV. Data on demographic characteristics, etiology of AHRF, comorbid conditions, ABG parameters, and outcomes were collected. NIV success was defined as the avoidance of intubation and improvement in clinical and ABG parameters.

Results: The study population had a mean age of 53.6 years, with males constituting 62% of the cohort. The primary etiologies of AHRF were pneumonia (43%), acute respiratory distress syndrome (ARDS) (32%), and chronic obstructive pulmonary disease (COPD) exacerbations (25%). NIV success was observed in 68% of patients. Significant predictors of NIV success included younger age, absence of comorbidities, higher initial pH, and lower APACHE II scores. NIV led to a significant improvement in ABG parameters, with mean PaO2/FiO2 ratio increasing from 100.2 ± 25.6 to 250.3 ± 50.8 mmHg (p < 0.01). Hospital mortality was significantly lower in the NIV success group compared to the NIV failure group (10% vs. 50%, p < 0.05).

Conclusion: NIV is an effective intervention for AHRF, particularly in patients without significant comorbidities and with favorable initial ABG parameters. Early identification of predictors for NIV success can optimize patient selection and improve clinical outcomes. Future studies should focus on refining NIV protocols and exploring adjunctive therapies to enhance NIV efficacy in AHRF.

Keywords: Cardiac manifestations, Dengue severity, Electrocardiographic findings, Echocardiographic assessment, Cardiac markers.