Introduction: Over a period of two years from December 2011 to July 2013 thirty patients (15 males and 15 females) were selected from admitted patients to the Critical Care department, Cairo University to be included in our study. Pts were subdivided into 2 groups septic group (I) and non-septic group (II). Septic group (I) meeting the criteria for sepsis and/or refractory circulatory failure and/or MODS while Group (II) will be pts subjected to Cardiac devices implantation in the Cath-lab. Methods: 20 patients (group I) with sepsis or septic shock were included and another 10 patients (group II) were served as Non-septic group. For group I, Morbidity and mortality at the day 28 in ICU were targeted as end point. Full history, examination and laboratory investigations were done, APACHE IV, SAPS II, SOFA scores were calculated. Biomarkers IL-1α, IL-1β, IL-6, IL-10, TNF α, CRP, NT-pro BNP and Troponin level were estimated on admission and day 7 in peripheral vein (PV) and coronary sinus (CS). Trans-Thoracic Echocardiography (TTE) and Tissue Doppler Imaging (TDI) was done on admission and on day 7. Results: Our study included 20 patients in sepsis and/or septic shock with mean age (52.25±17.45), Mortality rate in our study was 45%, upon comparing group (I) Vs group (II) there was a statistically significant difference regarding temperature (p=0.001), HR (p=0.001) and WBC count (p=0.01) on admission. then upon comparing survivors Vs non-survivors in group (I) there was a statistical difference in HR on day 7 (p=0.02), successful Vasopressors withdrawal (p=0.02). P/F ratio (p=0.02) and ScVO2 on day 7 ( p=0.03).Regarding IL-1α, IL-1β, TNF-α and Troponin I there was no statistical significant difference between group (I) and (II) but IL-6, IL-10 and CRP showed statistically significant difference on admission PV and CS. Pro-BNP shows statistically significant difference in all CS samples either between septic and non-septic groups. Regarding ECHO upon comparing the survivors Vs non-survivors E`d/t on day 0 shows a statistically significant difference between both groups, SAPS II and 7th day SOFA are good predictive scores to mortality in sepsis while predicted APACHE IV score for LOS showed a good correlation to the actual LOS in the ICU. Conclusion: Diastolic dysfunction was seen in 90% of patients. Body temperature, HR, WBC counts still good early indicators for diagnosis of sepsis. Higher P/F ratio, ScVO2 and Vasopressors withdrawal on 7th day were good predictors for survival. Admission serums IL-6, IL-10 and CRP from PV were better indicators for Sepsis than IL-1, Pro-BNP and Troponin I. Also admission TNF-α and 7th day IL-6 levels were highly prognostic to mortality. CS samples proved that NT Pro-BNP is a good indicator for sepsis diagnosis and a good predictor for survival, TNF-α from CS samples was also a good predictor for mortality. SAPS II and 7th day SOFA are good predictive scores to mortality in sepsis. Type I diastolic dysfunction was detected in 60% of septic patients and was associated with higher PO2 and shorter LOS on 7th day than Type III (seen in 30% of septic patients).A slower E`d/t on admission was the only Echocardiographic parameter predicts mortality.