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 aim 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 by the septic process, being at least as sensitive an indicator of left ventricular dysfunction as LVEF in these patients.


METHODS
Comparison of echocardiogram-derived LVEF with serum levels of troponin I in ten critically ill septic patients.


METHODS
General intensive care unit in a tertiary care private hospital.


METHODS
Ten critically ill septic patients with no previous documented heart disease.


RESULTS
Patients were simultaneously submitted to a two-dimensional 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 patients whose LVEF was < 0.5 had elevated troponin I levels (kappa = 0.61, p = 0.035).


CONCLUSIONS
Identification of myocardial dysfunction in septic patients has been a challenging task. Troponin I, a serum marker of myocardial injury, may be of great help in the recognition of myocardial involvement by sepsis in a noninvasive and readily available way.
Fernandes
C J
CJ
ICU, Hospital Israelita Albert Einstein, Av. Albert Einstein 627-5 degrees andar, CEP: 05651-901, São Paulo - SP, Brazil.
Akamine
N
N
Knobel
E
E
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016638:Critical Illness; D004311:Double-Blind Method; D004452:Echocardiography / Q000592:standards; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000150:complications* / Q000401:mortality; D013318:Stroke Volume; D016019:Survival Analysis; D019210:Troponin I / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology*; D016277:Ventricular Function, Left
D015415:Biomarkers; D019210:Troponin I