Alteration of myocardial performance, characterized by left ventricular
systolic and diastolic dysfunction, is a common and early complication of septic shock
and has a significant impact on patient's prognosis. Cardio-vascular biomarkers are
commonly used for diagnosis and risk stratification in cardiac patients. In particular,
troponins are included in the definition of acute coronary syndrome and natriuretic
peptides are the gold standard biomarkers for the diagnosis and the risk stratification of
acute heart failure. Interest has recently focused on the use of these biomarkers as tools
to identified cardiac sepsis-induced dysfunction and prognosis. Although
echocardiography would be needed to confirm the diagnosis of cardiac dysfunction,
biomarkers can alert physician and lead to perform a cardiac ultrasound. Whereas many
evidences suggest that cardiac troponins are useful in severe sepsis or septic shock to
identify those patients requiring early and aggressive therapy more studies are needed
before considering natriuretic peptides in this indication. Among the most recently
described biomarker, few data suggest that mid-regional pro-adrenomedullin (MRproADM)
could be useful for risk stratification of septic patients.
Keywords: Biomarkers, BNP, Lactate, Myocardial Depression, Septic Shock, Troponin.
