Cardiac troponin: a new serum marker of myocardial injury in sepsis

Objective: Echocardiogram-derived left Ventricular ejection fraction (LVEF) is usually utilized to evaluate left ventricular function, including that of septic patients. However, LVEF is greatly influenced by afterload. The a im of this study was to test the hypothesis that troponin I, a serum marker of myocardial injury, may be able to detect left ventricular involvement b y the septic process, being at least as sensitive an indicator of left vent ricular dysfunction as LVEF in these patients. Design: Comparison of echocardiogram-derived LVEF with serum levels of trop onin I in ten critically ill septic patients. Setting: General intensive care unit in a tertiary care private hospital. Patients: Ten critically ill septic patients with no previous documented he art disease. Measurements and results: Patients were simultaneously submitted to a two-d imensional echocardiogram and troponin I determinations. LVEFs and troponin I levels were analyzed in a two-by-two table in order to validate troponin I as a new biochemical marker of myocardial injury in sepsis. All the pati ents whose LVEF was < 0.5 had elevated troponin I levels (kappa = 0.61, p = 0.035). Conclusions: Identification of myocardial dysfunction in septic patients ha s been a challenging task. Troponin I, a serum marker of myocardial injury, may be of great help in the recognition of myocardial involvement by sepsi s in a noninvasive and readily available way.