Pathophysiology, echocardiographic evaluation, biomarker findings, and prognostic implications of septic cardiomyopathy: a review of the literature

Robert R Ehrman, Ashley N Sullivan, Mark J Favot, Robert L Sherwin, Christian A Reynolds, Aiden Abidov, Phillip D Levy, Robert R Ehrman, Ashley N Sullivan, Mark J Favot, Robert L Sherwin, Christian A Reynolds, Aiden Abidov, Phillip D Levy

Abstract

Background: Sepsis is a common condition encountered by emergency and critical care physicians, with significant costs, both economic and human. Myocardial dysfunction in sepsis is a well-recognized but poorly understood phenomenon. There is an extensive body of literature on this subject, yet results are conflicting and no objective definition of septic cardiomyopathy exists, representing a critical knowledge gap.

Objectives: In this article, we review the pathophysiology of septic cardiomyopathy, covering the effects of key inflammatory mediators on both the heart and the peripheral vasculature, highlighting the interconnectedness of these two systems. We focus on the extant literature on echocardiographic and laboratory assessment of the heart in sepsis, highlighting gaps therein and suggesting avenues for future research. Implications for treatment are briefly discussed.

Conclusions: As a result of conflicting data, echocardiographic measures of left ventricular (systolic or diastolic) or right ventricular function cannot currently provide reliable prognostic information in patients with sepsis. Natriuretic peptides and cardiac troponins are of similarly unclear utility. Heterogeneous classification of illness, treatment variability, and lack of formal diagnostic criteria for septic cardiomyopathy contribute to the conflicting results. Development of formal diagnostic criteria, and use thereof in future studies, may help elucidate the link between cardiac performance and outcomes in patients with sepsis.

Keywords: B-type natriuretic peptide; Echocardiography; Sepsis; Troponin; Ultrasound.

Conflict of interest statement

Competing interests

PL received consulting fees from the following companies/organizations: Novartis Pharmaceuticals, Cardiorentis Inc., Trevena Inc., Apex Innovations, Roche Diagnostics, Siemens, Shire, Sciex. PL received consulting fees from the following institutions/organizations: Novartis Pharmaceuticals, Cardiorentis Inc., Trevena Inc., Amgen, BMS, Edwards Lifesciences, AHRQ (1 R01 HS025411), NHLBI (1 R34 HL136986 and 5 R01 HL127215), NIH Admin (1 U24 NS100680), PCORI (FC14-1409-21,656), Blue Cross Blue Shield of MI Foundation. The other authors have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Pathophysiology of septic myocardial dysfunction. IL interleukin, iNOS induced nitric oxide synthase, PMN polymorphonuclear cell, TNF tumor necrosis factor
Fig. 2
Fig. 2
a Speckle-tracking analysis of a patient with normal systolic left ventricular (LV) function. 2D image showing speckles within the LV being tracked by the ultrasound Machine Software (A). Graphical representation of movement of speckles throughout the cardiac cycle (x-axis, longitudinal strain; y-axis, time in msec), with each line representing a different segment of the LV; large negative values represent movement of speckles towards one another during contraction representing normal function (B). Bullseye map showing global longitudinal strain values throughout the LV (C). b Speckle-tracking analysis of a patient with severely reduced left ventricular (LV) systolic function. A 2D image showing speckles within the LV being tracked by the ultrasound machine software (A). Graphical representation of movement of speckles throughout the cardiac cycle (x-axis, longitudinal strain; y-axis, time in msec) with each line representing a different segment of the LV; note smaller negative values with variable time to peak strain representing reduced LV function with mechanical dyssynchrony (B). Bullseye map showing global longitudinal strain values throughout the LV; blue zones represent areas of the LV where there is lengthening of the segments during systole rather than shortening (C)

References

    1. Parker MM, Shelhamer JH, Bacharach SL, Green MV, Natanson C, Frederick TM, Damske BA, Parrillo JE. Profound but reversible myocardial depression in patients with septic shock. Ann Intern Med. 1984;100(4):483–490. doi: 10.7326/0003-4819-100-4-483.
    1. Weisel RD, Vito L, Dennis RC, Valeri CR, Hechtman HB. Myocardial depression during sepsis. Am J Surg. 1977;133(4):512–521. doi: 10.1016/0002-9610(77)90141-6.
    1. Charpentier J, Luyt CE, Fulla Y, Vinsonneau C, Cariou A, Grabar S, Dhainaut JF, Mira JP, Chiche JD. Brain natriuretic peptide: A marker of myocardial dysfunction and prognosis during severe sepsis. Crit Care Med. 2004;32(3):660–665. doi: 10.1097/01.CCM.0000114827.93410.D8.
    1. Poelaert J, Declerck C, Vogelaers D, Colardyn F, Visser CA. Left ventricular systolic and diastolic function in septic shock. Intensive Care Med. 1997;23(5):553–560. doi: 10.1007/s001340050372.
    1. Kakihana Y, Ito T, Nakahara M, Yamaguchi K, Yasuda T. Sepsis-induced myocardial dysfunction: pathophysiology and management. J Intensive Care. 2016;4:22. doi: 10.1186/s40560-016-0148-1.
    1. Zanotti-Cavazzoni SL, Hollenberg SM. Cardiac dysfunction in severe sepsis and septic shock. Curr Opin Crit Care. 2009;15(5):392–397. doi: 10.1097/MCC.0b013e3283307a4e.
    1. Murphy CV, Schramm GE, Doherty JA, Reichley RM, Gajic O, Afessa B, Micek ST, Kollef MH. The importance of fluid management in acute lung injury secondary to septic shock. Chest. 2009;136(1):102–109. doi: 10.1378/chest.08-2706.
    1. Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF, Jr, Hite RD, Harabin AL. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354(24):2564–2575. doi: 10.1056/NEJMoa062200.
    1. Schneider AJ, Teule GJ, Groeneveld AB, Nauta J, Heidendal GA, Thijs LG. Biventricular performance during volume loading in patients with early septic shock, with emphasis on the right ventricle: a combined hemodynamic and radionuclide study. Am Heart J. 1988;116(1 Pt 1):103–112. doi: 10.1016/0002-8703(88)90256-6.
    1. Maeder M, Fehr T, Rickli H, Ammann P. Sepsis-associated myocardial dysfunction: diagnostic and prognostic impact of cardiac troponins and natriuretic peptides. Chest. 2006;129(5):1349–1366. doi: 10.1378/chest.129.5.1349.
    1. Russell JA, Boyd J, Nakada T, Thair S, Walley KR. Molecular mechanisms of sepsis. Contrib Microbiol. 2011;17:48–85. doi: 10.1159/000324009.
    1. Conway-Morris A, Wilson J, Shankar-Hari M. Immune activation in sepsis. Crit Care Clin. 2018;34(1):29–42. doi: 10.1016/j.ccc.2017.08.002.
    1. Anthonymuthu TS, Kim-Campbell N, Bayir H. Oxidative lipidomics: applications in critical care. Curr Opin Crit Care. 2017;23(4):251–256. doi: 10.1097/MCC.0000000000000419.
    1. Bednarczyk JM, Fridfinnson JA, Kumar A, Blanchard L, Rabbani R, Bell D, Funk D, Turgeon AF, Abou-Setta AM, Zarychanski R. Incorporating dynamic assessment of fluid responsiveness into goal-directed therapy: a systematic review and meta-analysis. Crit Care Med. 2017;45(9):1538–1545. doi: 10.1097/CCM.0000000000002554.
    1. Cherpanath TG, Hirsch A, Geerts BF, Lagrand WK, Leeflang MM, Schultz MJ, Groeneveld AB. Predicting fluid responsiveness by passive leg raising: a systematic review and meta-analysis of 23 clinical trials. Crit Care Med. 2016;44(5):981–991. doi: 10.1097/CCM.0000000000001556.
    1. Ma IWY, Caplin JD, Azad A, Wilson C, Fifer MA, Bagchi A, Liteplo AS, Noble VE. Correlation of carotid blood flow and corrected carotid flow time with invasive cardiac output measurements. Crit Ultrasound J. 2017;9(1):10. doi: 10.1186/s13089-017-0065-0.
    1. Boissier F, Razazi K, Seemann A, Bedet A, Thille AW, de Prost N, Lim P, Brun-Buisson C, Mekontso Dessap A. Left ventricular systolic dysfunction during septic shock: the role of loading conditions. Intensive Care Med. 2017;43(5):633–642. doi: 10.1007/s00134-017-4698-z.
    1. Bruni FD, Komwatana P, Soulsby ME, Hess ML. Endotoxin and myocardial failure: role of the myofibril and venous return. Am J Phys. 1978;235(2):H150–H156.
    1. Cunnion RE, Schaer GL, Parker MM, Natanson C, Parrillo JE. The coronary circulation in human septic shock. Circulation. 1986;73(4):637–644. doi: 10.1161/01.CIR.73.4.637.
    1. Sato R, Nasu M. A review of sepsis-induced cardiomyopathy. J Intensive Care. 2015;3:48. doi: 10.1186/s40560-015-0112-5.
    1. Madorin WS, Rui T, Sugimoto N, Handa O, Cepinskas G, Kvietys PR. Cardiac myocytes activated by septic plasma promote neutrophil transendothelial migration: role of platelet-activating factor and the chemokines LIX and KC. Circ Res. 2004;94(7):944–951. doi: 10.1161/.
    1. Rudiger A, Singer M. Mechanisms of sepsis-induced cardiac dysfunction. Crit Care Med. 2007;35(6):1599–1608. doi: 10.1097/01.CCM.0000266683.64081.02.
    1. Celes MR, Torres-Duenas D, Malvestio LM, Blefari V, Campos EC, Ramos SG, Prado CM, Cunha FQ, Rossi MA. Disruption of sarcolemmal dystrophin and beta-dystroglycan may be a potential mechanism for myocardial dysfunction in severe sepsis. Lab Investig. 2010;90(4):531–542. doi: 10.1038/labinvest.2010.3.
    1. Jardin F, Fourme T, Page B, Loubieres Y, Vieillard-Baron A, Beauchet A, Bourdarias JP. Persistent preload defect in severe sepsis despite fluid loading: A longitudinal echocardiographic study in patients with septic shock. Chest. 1999;116(5):1354–1359. doi: 10.1378/chest.116.5.1354.
    1. Siddiqui Y, Crouser ED, Raman SV. Nonischemic myocardial changes detected by cardiac magnetic resonance in critical care patients with sepsis. Am J Respir Crit Care Med. 2013;188(8):1037–1039. doi: 10.1164/rccm.201304-0744LE.
    1. Levy RJ, Piel DA, Acton PD, Zhou R, Ferrari VA, Karp JS, Deutschman CS. Evidence of myocardial hibernation in the septic heart. Crit Care Med. 2005;33(12):2752–2756. doi: 10.1097/01.CCM.0000189943.60945.77.
    1. Budinger GR, Duranteau J, Chandel NS, Schumacker PT. Hibernation during hypoxia in cardiomyocytes. Role of mitochondria as the O2 sensor. J Biol Chem. 1998;273(6):3320–3326. doi: 10.1074/jbc.273.6.3320.
    1. Cappelletti S, Ciallella C, Aromatario M, Ashrafian H, Harding S, Athanasiou T. Takotsubo Cardiomyopathy and Sepsis. Angiology. 2017;68(4):288–303. doi: 10.1177/0003319716653886.
    1. Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, Vist GE, Falck-Ytter Y, Meerpohl J, Norris S, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401–406. doi: 10.1016/j.jclinepi.2010.07.015.
    1. McLean AS, Huang SJ, Hyams S, Poh G, Nalos M, Pandit R, Balik M, Tang B, Seppelt I. Prognostic values of B-type natriuretic peptide in severe sepsis and septic shock. Crit Care Med. 2007;35(4):1019–1026. doi: 10.1097/01.CCM.0000259469.24364.31.
    1. Pulido JN, Afessa B, Masaki M, Yuasa T, Gillespie S, Herasevich V, Brown DR, Oh JK. Clinical spectrum, frequency, and significance of myocardial dysfunction in severe sepsis and septic shock. Mayo Clin Proc. 2012;87(7):620–628. doi: 10.1016/j.mayocp.2012.01.018.
    1. Huang SJ, Nalos M, McLean AS. Is early ventricular dysfunction or dilatation associated with lower mortality rate in adult severe sepsis and septic shock? A meta-analysis. Crit Care. 2013;17(3):R96. doi: 10.1186/cc12741.
    1. Sevilla Berrios RA, O'Horo JC, Velagapudi V, Pulido JN. Correlation of left ventricular systolic dysfunction determined by low ejection fraction and 30-day mortality in patients with severe sepsis and septic shock: a systematic review and meta-analysis. J Crit Care. 2014;29(4):495–499. doi: 10.1016/j.jcrc.2014.03.007.
    1. Smiseth OA, Torp H, Opdahl A, Haugaa KH, Urheim S. Myocardial strain imaging: how useful is it in clinical decision making? Eur Heart J. 2016;37(15):1196–1207. doi: 10.1093/eurheartj/ehv529.
    1. Kaluzynski K, Chen X, Emelianov SY, Skovoroda AR, O'Donnell M. Strain rate imaging using two-dimensional speckle tracking. IEEE Trans Ultrason Ferroelectr Freq Control. 2001;48(4):1111–1123. doi: 10.1109/58.935730.
    1. Basu S, Frank LH, Fenton KE, Sable CA, Levy RJ, Berger JT. Two-dimensional speckle tracking imaging detects impaired myocardial performance in children with septic shock, not recognized by conventional echocardiography. Pediatr Crit Care Med. 2012;13(3):259–264. doi: 10.1097/PCC.0b013e3182288445.
    1. Kalam K, Otahal P, Marwick TH. Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction. Heart. 2014;100(21):1673–1680. doi: 10.1136/heartjnl-2014-305538.
    1. Ng PY, Sin WC, Ng AK, Chan WM. Speckle tracking echocardiography in patients with septic shock: a case control study (SPECKSS) Crit Care. 2016;20(1):145. doi: 10.1186/s13054-016-1327-0.
    1. Chang WT, Lee WH, Lee WT, Chen PS, Su YR, Liu PY, Liu YW, Tsai WC. Left ventricular global longitudinal strain is independently associated with mortality in septic shock patients. Intensive Care Med. 2015;41(10):1791–1799. doi: 10.1007/s00134-015-3970-3.
    1. Palmieri V, Innocenti F, Guzzo A, Guerrini E, Vignaroli D, Pini R. Left ventricular systolic longitudinal function as predictor of outcome in patients with sepsis. Circ Cardiovasc Imaging. 2015;8(11):e003865.
    1. Innocenti F, Palmieri V, Guzzo A, Stefanone VT, Donnini C, Pini R. SOFA score and left ventricular systolic function as predictors of short-term outcome in patients with sepsis. Internal and emergency medicine. 2018;13(1):51–58.
    1. Orde SR, Pulido JN, Masaki M, Gillespie S, Spoon JN, Kane GC, Oh JK. Outcome prediction in sepsis: speckle tracking echocardiography based assessment of myocardial function. Crit Care. 2014;18(4):R149. doi: 10.1186/cc13987.
    1. De Geer L, Engvall J, Oscarsson A. Strain echocardiography in septic shock - a comparison with systolic and diastolic function parameters, cardiac biomarkers and outcome. Crit Care. 2015;19:122. doi: 10.1186/s13054-015-0857-1.
    1. Zaky A, Gill EA, Lin CP, Paul CP, Bendjelid K, Treggiari MM. Characteristics of sepsis-induced cardiac dysfunction using speckle-tracking echocardiography: a feasibility study. Anaesth Intensive Care. 2016;44(1):65–76.
    1. Dalla K, Hallman C, Bech-Hanssen O, Haney M, Ricksten SE. Strain echocardiography identifies impaired longitudinal systolic function in patients with septic shock and preserved ejection fraction. Cardiovasc Ultrasound. 2015;13:30. doi: 10.1186/s12947-015-0025-4.
    1. De Geer L, Oscarsson A, Engvall J. Variability in echocardiographic measurements of left ventricular function in septic shock patients. Cardiovasc Ultrasound. 2015;13:19. doi: 10.1186/s12947-015-0015-6.
    1. Yu CM, Sanderson JE, Marwick TH, Oh JK. Tissue Doppler imaging a new prognosticator for cardiovascular diseases. J Am Coll Cardiol. 2007;49(19):1903–1914. doi: 10.1016/j.jacc.2007.01.078.
    1. Paraskevaidis IA, Kyrzopoulos S, Farmakis D, Parissis J, Tsiapras D, Iliodromitis EK, Kremastinos DT. Ventricular long-axis contraction as an earlier predictor of outcome in asymptomatic aortic regurgitation. Am J Cardiol. 2007;100(11):1677–1682. doi: 10.1016/j.amjcard.2007.06.074.
    1. Weng L, Liu YT, Du B, Zhou JF, Guo XX, Peng JM, Hu XY, Zhang SY, Fang Q, Zhu WL. The prognostic value of left ventricular systolic function measured by tissue Doppler imaging in septic shock. Crit Care. 2012;16(3):R71. doi: 10.1186/cc11328.
    1. Weng L, Liu Y, Zhou J, Guo X, Peng J, Hu X, Fang Q, Zhu W, Li H, Du B, et al. Left ventricular systolic function and systolic asynchrony in patients with septic shock and normal left ventricular ejection fraction. Shock (Augusta, GA) 2013;40(3):175–181. doi: 10.1097/SHK.0b013e31829dcfef.
    1. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF, 3rd, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17(12):1321–1360. doi: 10.1093/ehjci/jew082.
    1. Brown SM, Pittman JE, Hirshberg EL, Jones JP, Lanspa MJ, Kuttler KG, Litwin SE, Grissom CK. Diastolic dysfunction and mortality in early severe sepsis and septic shock: a prospective, observational echocardiography study. Crit Ultrasound J. 2012;4(1):8. doi: 10.1186/2036-7902-4-8.
    1. Mahjoub Y, Benoit-Fallet H, Airapetian N, Lorne E, Levrard M, Seydi AA, Amennouche N, Slama M, Dupont H. Improvement of left ventricular relaxation as assessed by tissue Doppler imaging in fluid-responsive critically ill septic patients. Intensive Care Med. 2012;38(9):1461–1470. doi: 10.1007/s00134-012-2618-9.
    1. Landesberg G, Gilon D, Meroz Y, Georgieva M, Levin PD, Goodman S, Avidan A, Beeri R, Weissman C, Jaffe AS, et al. Diastolic dysfunction and mortality in severe sepsis and septic shock. Eur Heart J. 2012;33(7):895–903. doi: 10.1093/eurheartj/ehr351.
    1. Landesberg G, Jaffe AS, Gilon D, Levin PD, Goodman S, Abu-Baih A, Beeri R, Weissman C, Sprung CL, Landesberg A. Troponin elevation in severe sepsis and septic shock: the role of left ventricular diastolic dysfunction and right ventricular dilatation. Crit Care Med. 2014;42(4):790–800. doi: 10.1097/CCM.0000000000000107.
    1. Sturgess DJ, Marwick TH, Joyce C, Jenkins C, Jones M, Masci P, Stewart D, Venkatesh B. Prediction of hospital outcome in septic shock: a prospective comparison of tissue Doppler and cardiac biomarkers. Crit Care. 2010;14(2):R44. doi: 10.1186/cc8931.
    1. Rolando G, Espinoza ED, Avid E, Welsh S, Pozo JD, Vazquez AR, Arzani Y, Masevicius FD, Dubin A. Prognostic value of ventricular diastolic dysfunction in patients with severe sepsis and septic shock. Rev Bras Ter Intensiva. 2015;27(4):333–339. doi: 10.5935/0103-507X.20150057.
    1. Sanfilippo F, Corredor C, Fletcher N, Landesberg G, Benedetto U, Foex P, Cecconi M. Diastolic dysfunction and mortality in septic patients: a systematic review and meta-analysis. Intensive Care Med. 2015;41(6):1004–1013. doi: 10.1007/s00134-015-3748-7.
    1. Sanfilippo F, Corredor C, Arcadipane A, Landesberg G, Vieillard-Baron A, Cecconi M, Fletcher N. Tissue Doppler assessment of diastolic function and relationship with mortality in critically ill septic patients: a systematic review and meta-analysis. Br J Anaesth. 2017;119(4):583–594. doi: 10.1093/bja/aex254.
    1. Lanspa MJ, Gutsche AR, Wilson EL, Olsen TD, Hirshberg EL, Knox DB, Brown SM, Grissom CK. Application of a simplified definition of diastolic function in severe sepsis and septic shock. Crit Care. 2016;20(1):243. doi: 10.1186/s13054-016-1421-3.
    1. Damy T, Ghio S, Rigby AS, Hittinger L, Jacobs S, Leyva F, Delgado JF, Daubert JC, Gras D, Tavazzi L, et al. Interplay between right ventricular function and cardiac resynchronization therapy: an analysis of the CARE-HF trial (Cardiac Resynchronization-Heart Failure) J Am Coll Cardiol. 2013;61(21):2153–2160. doi: 10.1016/j.jacc.2013.02.049.
    1. Forfia PR, Fisher MR, Mathai SC, Housten-Harris T, Hemnes AR, Borlaug BA, Chamera E, Corretti MC, Champion HC, Abraham TP, et al. Tricuspid annular displacement predicts survival in pulmonary hypertension. Am J Respir Crit Care Med. 2006;174(9):1034–1041. doi: 10.1164/rccm.200604-547OC.
    1. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2015;16(3):233–270. doi: 10.1093/ehjci/jev014.
    1. Gajanana D, Seetha Rammohan H, Alli O, Romero-Corral A, Purushottam B, Ponamgi S, Figueredo VM, Pressman GS. Tricuspid annular plane systolic excursion and its association with mortality in critically ill patients. Echocardiography (Mount Kisco, NY) 2015;32(8):1222–1227. doi: 10.1111/echo.12926.
    1. Zhang HM, Wang XT, Zhang LN, He W, Zhang Q, Liu DW. Left ventricular longitudinal systolic function in septic shock patients with normal ejection fraction: a case-control study. Chin Med J. 2017;130(10):1169–1174. doi: 10.4103/0366-6999.205849.
    1. Furian T, Aguiar C, Prado K, Ribeiro RV, Becker L, Martinelli N, Clausell N, Rohde LE, Biolo A. Ventricular dysfunction and dilation in severe sepsis and septic shock: relation to endothelial function and mortality. J Crit Care. 2012;27(3):319 e319–319 e315. doi: 10.1016/j.jcrc.2011.06.017.
    1. Vallabhajosyula S, Kumar M, Pandompatam G, Sakhuja A, Kashyap R, Kashani K, Gajic O, Geske JB, Jentzer JC. Prognostic impact of isolated right ventricular dysfunction in sepsis and septic shock: an 8-year historical cohort study. Ann Intensive Care. 2017;7(1):94. doi: 10.1186/s13613-017-0319-9.
    1. Wu AH. Increased troponin in patients with sepsis and septic shock: myocardial necrosis or reversible myocardial depression? Intensive Care Med. 2001;27(6):959–961. doi: 10.1007/s001340100970.
    1. Cheng H, Fan WZ, Wang SC, Liu ZH, Zang HL, Wang LZ, Liu HJ, Shen XH, Liang SQ. N-terminal pro-brain natriuretic peptide and cardiac troponin I for the prognostic utility in elderly patients with severe sepsis or septic shock in intensive care unit: A retrospective study. J Crit Care. 2015;30(3):654 e659–654 e614. doi: 10.1016/j.jcrc.2014.12.008.
    1. Rosjo H, Varpula M, Hagve TA, Karlsson S, Ruokonen E, Pettila V, Omland T. Circulating high sensitivity troponin T in severe sepsis and septic shock: distribution, associated factors, and relation to outcome. Intensive Care Med. 2011;37(1):77–85. doi: 10.1007/s00134-010-2051-x.
    1. Vallabhajosyula S, Sakhuja A, Geske JB, Kumar M, Poterucha JT, Kashyap R, Kashani K, Jaffe AS, Jentzer JC. Role of admission troponin-T and serial troponin-T testing in predicting outcomes in severe sepsis and septic shock. J Am Heart Assoc. 2017;6(9) 10.1161/JAHA.117.005930.
    1. Masson S, Caironi P, Fanizza C, Carrer S, Caricato A, Fassini P, Vago T, Romero M, Tognoni G, Gattinoni L, et al. Sequential N-terminal pro-B-type natriuretic peptide and high-sensitivity cardiac troponin measurements during albumin replacement in patients with severe sepsis or septic shock. Crit Care Med. 2016;44(4):707–716.
    1. de Lemos JA, McGuire DK, Drazner MH. B-type natriuretic peptide in cardiovascular disease. Lancet (London, England) 2003;362(9380):316–322. doi: 10.1016/S0140-6736(03)13976-1.
    1. Richards AM, Crozier IG, Yandle TG, Espiner EA, Ikram H, Nicholls MG. Brain natriuretic factor: regional plasma concentrations and correlations with haemodynamic state in cardiac disease. Br Heart J. 1993;69(5):414–417. doi: 10.1136/hrt.69.5.414.
    1. Varpula M, Pulkki K, Karlsson S, Ruokonen E, Pettila V. Predictive value of N-terminal pro-brain natriuretic peptide in severe sepsis and septic shock. Crit Care Med. 2007;35(5):1277–1283. doi: 10.1097/01.CCM.0000261893.72811.0F.
    1. Ikonomidis I, Nikolaou M, Dimopoulou I, Paraskevaidis I, Lekakis J, Mavrou I, Tzanela M, Kopterides P, Tsangaris I, Armaganidis A, et al. Association of left ventricular diastolic dysfunction with elevated NT-pro-BNP in general intensive care unit patients with preserved ejection fraction: a complementary role of tissue Doppler imaging parameters and NT-pro-BNP levels for adverse outcome. Shock (Augusta, Ga) 2010;33(2):141–148. doi: 10.1097/SHK.0b013e3181ad31f8.
    1. Ostermann M, Ayis S, Tuddenham E, Lo J, Lei K, Smith J, Sanderson B, Moran C, Collinson P, Peacock J, et al. Cardiac troponin release is associated with biomarkers of inflammation and ventricular dilatation during critical illness. Shock (Augusta, Ga) 2017;47(6):702–708. doi: 10.1097/SHK.0000000000000811.
    1. Nizamuddin J, Mahmood F, Tung A, Mueller A, Brown SM, Shaefi S, O'Connor M, Talmor D, Shahul S. Interval changes in myocardial performance index predict outcome in severe sepsis. J Cardiothorac Vasc Anesth. 2017;31(3):957–964. doi: 10.1053/j.jvca.2016.11.007.
    1. Velissaris D, Pierrakos C, Scolletta S, De Backer D, Vincent JL. High mixed venous oxygen saturation levels do not exclude fluid responsiveness in critically ill septic patients. Crit Care. 2011;15(4):R177. doi: 10.1186/10326.
    1. Sanfilippo F, Santonocito C, Morelli A, Foex P. Beta-blocker use in severe sepsis and septic shock: a systematic review. Curr Med Res Opin. 2015;31(10):1817–1825. doi: 10.1185/03007995.2015.1062357.
    1. Zangrillo A, Putzu A, Monaco F, Oriani A, Frau G, De Luca M, Di Tomasso N, Bignami E, Lomivorotov V, Likhvantsev V, et al. Levosimendan reduces mortality in patients with severe sepsis and septic shock: A meta-analysis of randomized trials. J Crit Care. 2015;30(5):908–913. doi: 10.1016/j.jcrc.2015.05.017.
    1. Gordon AC, Perkins GD, Singer M, McAuley DF, Orme RM, Santhakumaran S, Mason AJ, Cross M, Al-Beidh F, Best-Lane J, et al. Levosimendan for the prevention of acute organ dysfunction in sepsis. N Engl J Med. 2016;375(17):1638–1648. doi: 10.1056/NEJMoa1609409.

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