Background: Sepsis was one of health problem which cause a high risk of morbidityand mortality. Releasing cytokines pro inflammatory with other factors caused LeftVentricular Systolic Dysfunction (LVSD). In sepsis, there was a releasing of MR proANP, PCT and TNF-a because of cytokines pro inflammatory stimulation.Objectives: To prove MR pro ANP as LVSD biomarker, to determine AUC value,sensitivity, specificity, cut off point value, and probability of MR pro ANP, PCT andTNF-a as LVSD biomarker, to analyse the correlation between TNF-a and MR proANP, the correlation between MR pro ANP and PCT, to find out the best diagnosticpredictor of LVSD.Methods: Non experimental diagnostic test using cross sectional design. The simplerandom sampling was taken consist of 71 sepsis patients. Variables examined wereMR pro ANP, PCT and TNF-a, and LVEF was examined using echocardiograph(Simpson method). LVSD occurred if LVEF was = 45%. Data were analysed using2x2 table and ROC curve and statistically analysed with SPSS 22 for window.Results: AUC value of MR pro ANP was 0,84 (95% CI 0,73-0,95), p <0,001. Cut offpoint of MR pro ANP was = 225,95 pmol/L with DOR 12,11 (95% CI 3,66-40,12).AUC value of PCT was 0,81 (95% CI 0,71-0,91), p<0,001. Cut off point of PCT was=7,875 ng/mL with DOR 5,55 (95% CI 1,88-16,42). AUC value of TNF-a was 0,73(95% CI 0,60 - 0,86), p< 0,002. Cut off point of TNF-a was = 7,36 pg/mL with DOR5,03 (95% CI 1,71-14,77). There was a weak positive correlation between TNF-a andMR pro ANP (r=0,197, p=0,100). There was a positive correlation between PCT andMR pro ANP (r=0,309, p=0,009). Multivariate analysis found MR pro ANP as thebest predictor for LVSD (AUC 0,78), PCT (AUC 0,70), and TNF-a (AUC 0,69). Thecombination of MR pro ANP + PCT would increase diagnostic value with AUC 0,87.Conclusions: MR pro ANP could be used as LVSD biomarker with AUC 0,84 (95%CI 0,73-0,95), p <0,001, cut off point value = 225,95 pmol/L, DOR 12,11. AUC ofPCT was 0,81 (95% CI 0,71-0,91), p<0,001, cut off point value =7,875ng/mL, DOR5,55. AUC of TNF-a was 0,71 (95% CI 0,60 - 0,86), p< 0,002, cut off point value =7,36 pg / mL, DOR 5,03. There was a weak positive correlation between TNF-a andMR pro ANP. PCT had a positive correlation with MR pro ANP. MR pro ANP wasthe best LVSD diagnostic predictor. The combination of MR pro ANP + PCT was thebest and efficient diagnostic predictor of LVSD.Keywords : Biomarker, Left Ventricular Systolic Dysfunction , MR pro ANP, PCT,TNF-a.