Frontiers in Myocardia

Volume: 1

Which Biomarkers Can I Use to Manage Septic Cardiomyopathy

Author(s): Anaïs Caillard, Etienne Gayat, Dahdouh Souheila and Alexandre Mebazaa

Pp: 154-163 (10)

DOI: 10.2174/9781681080604115010013

* (Excluding Mailing and Handling)

Abstract

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.

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      • 11. app/Models/ContentAccess.php:647
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      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 58768607 and j.to_ip >=58768607 )) and ((j.from_date <= 1740422447 and j.to_date >= 1740422447 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7802) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 58768607 and j.to_ip >=58768607 )) and ((j.from_date <= 1740422447 and j.to_date >= 1740422447 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7802) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 58768607 and j.to_ip >=58768607 )) and ((j.from_date <= 1740422447 and j.to_date >= 1740422447 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7802)
      590μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 1734 and `b`.`banner_from_date` <= 1740422447 and `b`.`banner_to_date` >= 1740422447 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.1msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 1734
      • 3: 1740422447
      • 4: 1740422447
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='e3b2bf12f2d3e97229c270e25ede7747'
      240μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    6Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        2RWBeMDD8GFxDJ9wpbQEG0ZlSd0UUWuLR0JehLSx
        uc_cart_id
        e3b2bf12f2d3e97229c270e25ede7747
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7802" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/7802
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:16 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        []
        
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Mon, 24 Feb 2025 18:40:47 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6InZPSzl4V0FhMWpWMHJvK21leVNnUlE9PSIsInZhbHVlIjoiSENIUDErZFpCSXNNNXU3SHNWYi9OTnZ5Q1gwSXRqemhrMkhrNEtkWDkxZEN3c21wdVZaZlphNGVkUDBDMW9HcW5GZzhhWElCenFMbnljSGhieDlyM3N5Zjl4NVRzaU1HbmJGNFFUZVNDckhlRkRMZ3R2ME8rVEF3MXpNK1dKWW0iLCJtYWMiOiI1MDliMzQyNjQ1MDY1Yzc3YTRhZGI5Zjc3NWM5OGM4NWE5N2Y2MmRhZTU2MmMxNWJkNGExMDQ0MGQwOGY1YmNiIiwidGFnIjoiIn0%3D; expires=Thu, 27 Feb 2025 06:40:47 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6InZPSzl4V0FhMWpWMHJvK21leVNnUlE9PSIsInZhbHVlIjoiSENIUDErZFpCSXNNNXU3SHNWYi9OTnZ5Q1gwSXRqemhrMkhrNEtkWDkxZEN3c21wdVZaZlphNGVkUDBDMW9HcW5GZzhhW" 1 => "alphaeurekaselectnet_session=eyJpdiI6Ik9zSlJUQWZpRlFJTFZVTzg1OEJrcnc9PSIsInZhbHVlIjoiUThGNklPRUh1cTVaK2h5dUhDalZ6Q2ViVjRrcFNMTTYrZmhnbnc2NkMzYjNid21JeXdhYStCeDVqN2JjT3E4NmlVSE1jV0lreGlYTDlhalppUFFVVW4xdldObWFpekl1MDFCTEI2TUNLS2FjZXo2Sjc2dlhBUEQwaFZmc1pPbEoiLCJtYWMiOiIyMjA5MGQ4NDMwZThiOTRiYTZjNjkyZjNhY2UxYzNiNGZmMTFiMWE1NjIyNTYwMmEzODhmMzhlN2YxNGU5OWEwIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6Ik9zSlJUQWZpRlFJTFZVTzg1OEJrcnc9PSIsInZhbHVlIjoiUThGNklPRUh1cTVaK2h5dUhDalZ6Q2ViVjRrcFNMTTYrZmhnbnc2NkMzYjNid21JeXdhYStCeDV" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6InZPSzl4V0FhMWpWMHJvK21leVNnUlE9PSIsInZhbHVlIjoiSENIUDErZFpCSXNNNXU3SHNWYi9OTnZ5Q1gwSXRqemhrMkhrNEtkWDkxZEN3c21wdVZaZlphNGVkUDBDMW9HcW5GZzhhWElCenFMbnljSGhieDlyM3N5Zjl4NVRzaU1HbmJGNFFUZVNDckhlRkRMZ3R2ME8rVEF3MXpNK1dKWW0iLCJtYWMiOiI1MDliMzQyNjQ1MDY1Yzc3YTRhZGI5Zjc3NWM5OGM4NWE5N2Y2MmRhZTU2MmMxNWJkNGExMDQ0MGQwOGY1YmNiIiwidGFnIjoiIn0%3D; expires=Thu, 27-Feb-2025 06:40:47 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6InZPSzl4V0FhMWpWMHJvK21leVNnUlE9PSIsInZhbHVlIjoiSENIUDErZFpCSXNNNXU3SHNWYi9OTnZ5Q1gwSXRqemhrMkhrNEtkWDkxZEN3c21wdVZaZlphNGVkUDBDMW9HcW5GZzhhW" 1 => "alphaeurekaselectnet_session=eyJpdiI6Ik9zSlJUQWZpRlFJTFZVTzg1OEJrcnc9PSIsInZhbHVlIjoiUThGNklPRUh1cTVaK2h5dUhDalZ6Q2ViVjRrcFNMTTYrZmhnbnc2NkMzYjNid21JeXdhYStCeDVqN2JjT3E4NmlVSE1jV0lreGlYTDlhalppUFFVVW4xdldObWFpekl1MDFCTEI2TUNLS2FjZXo2Sjc2dlhBUEQwaFZmc1pPbEoiLCJtYWMiOiIyMjA5MGQ4NDMwZThiOTRiYTZjNjkyZjNhY2UxYzNiNGZmMTFiMWE1NjIyNTYwMmEzODhmMzhlN2YxNGU5OWEwIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6Ik9zSlJUQWZpRlFJTFZVTzg1OEJrcnc9PSIsInZhbHVlIjoiUThGNklPRUh1cTVaK2h5dUhDalZ6Q2ViVjRrcFNMTTYrZmhnbnc2NkMzYjNid21JeXdhYStCeDV" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "2RWBeMDD8GFxDJ9wpbQEG0ZlSd0UUWuLR0JehLSx" "uc_cart_id" => "e3b2bf12f2d3e97229c270e25ede7747" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7802" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-24 18:40:47GET/chapter/7802112198