A burning issue: do sepsis and systemic inflammatory response syndrome (SIRS) directly contribute to cardiac dysfunction?

Ren, Jun; Wu, Shan

doi:10.2741/1776

Cited by 59 publications

(41 citation statements)

References 65 publications

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“…Cardiac dysfunction is a consequence of severe sepsis [3–5] and is characterized by impaired contractility [6], diastolic dysfunction, as well as reduced cardiac index and ejection fraction (EF) [7]. Cardiac dysfunction is an important component of multiorgan failure that is caused by severe sepsis [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology of Sepsis-Related Cardiac Dysfunction: Driven by Inflammation, Energy Mismanagement, or Both?

Drosatos

Lymperopoulos

Kennel

et al. 2014

Curr Heart Fail Rep

186

166

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Sepsis is a systemic inflammatory response that follows bacterial infection. Cardiac dysfunction is an important consequence of sepsis that affects mortality and has been attributed to either elevated inflammation or suppression of both fatty acid and glucose oxidation and eventual ATP depletion. Moreover, cardiac adrenergic signaling is compromised in septic patients and this aggravates further heart function. While anti-inflammatory therapies are important for the treatment of the disease, administration of anti-inflammatory drugs did not improve survival in septic patients. This review article summarizes findings on inflammatory and other mechanisms that are triggered in sepsis and affect cardiac function and mortality. Particularly, it focuses on the effects of the disease in metabolic pathways, as well as in adrenergic signaling and the potential interplay of the latter with inflammation. It is suggested that therapeutic approaches should include combination of anti-inflammatory treatments, stimulation of energy production, and restoration of adrenergic signaling in the heart.

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Section: Introductionmentioning

confidence: 99%

Pathophysiology of Sepsis-Related Cardiac Dysfunction: Driven by Inflammation, Energy Mismanagement, or Both?

Drosatos

Lymperopoulos

Kennel

et al. 2014

Curr Heart Fail Rep

186

166

View full text Add to dashboard Cite

show abstract

“…A subset of proteasomes known as immunoproteasomes regulates antigen presentation and immune function 48 . Cardiac dysfunctions are major complications in patients with trauma, infection, or burns 49 . Since cardiac proteasome functionality may be a limiting factor in maintaining cardiac function during severe inflammation, we assessed proteasome activity.…”

Section: Discussionmentioning

confidence: 99%

Age influences inflammatory responses, hemodynamics, and cardiac proteasome activation during acute lung injury

Linge

Lee

Ochani

et al. 2015

Experimental Lung Research

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Background Acute lung injury (ALI) is a significant source of morbidity and mortality in critically ill patients. Age is a major determinant of clinical outcome in ALI. The increased ALI-associated mortality in the older population suggests that there are age-dependent alterations in the responses to pulmonary challenge. The objective of this observational study was to evaluate age-dependent differences in the acute (within 6hrs) immunological and physiological responses of the heart and lung, to pulmonary challenge, that could result in increased severity. Methods Male C57Bl/6 mice (young: 2–3 months, old: 18–20 months) were challenged intratracheally with cell wall components from gram positive bacteria (lipoteichoic acid and peptidoglycan). After 6h, both biochemical and physiological consequences of the challenge were assessed. Alveolar infiltration of inflammatory cells and protein, airspace and blood cytokines, cardiac function and myocardial proteasome activity were determined. Results In young mice there was a dose dependent response to pulmonary challenge resulting in increased airspace neutrophil counts, lung permeability, and concentrations of cytokines in bronchoalveolar lavage fluid and plasma. A midrange dose was then selected to compare the responses in young and old animals. In comparison, the old animals displayed increased neutrophil accumulation in the airspaces, decreased arterial oxygen saturation, body temperatures, plasma cytokine concentrations, and a lack of myocardial proteasome response, following challenge. Conclusions Age dependent differences in the onset of systemic response and in maintenance of vital functions, including temperature control, oxygen saturation and myocardial proteasome activation, are evident. We believe a better understanding of these age-related consequences of ALI can lead to more appropriate treatments in the elderly patient population.

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“…In sepsis, this dysfunction is caused by impaired myocardial compliance and decreased contractility. Possible explanations for the underlying mechanisms involve global ischemia, lysozyme c, prostanoids, activation of adhesion molecules, Toll-like receptor signaling, endothelin-1, nitric oxide (NO), and inflammatory cytokines (8,11,14,15). Several different ways by which estrogen administration exerts its influence under such conditions have been identified.…”

Section: Physiology: Cardiovascular Systemmentioning

confidence: 97%

Estrogen and multiple organ dysfunction syndrome in critical illness: From bench to bedside

Nickel

Schwacha

Chaudry

2008

Journal of Organ Dysfunction

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For 100 years, researchers and medical professionals have been aware of a gender difference in immune responsiveness following insults like trauma, shock, burn or sepsis. Strong experimental evidence indicates that female animals are protected under such conditions compared to their male counterparts. 17b-estradiol (estrogen) is reported to be responsible for those protective effects as studies have shown that estrogen administration plays a major role in the restoration and maintenance of cellular and organ function following injury. Numerous experimental studies have also shown a variety of salutary effects of estrogen under low-flow conditions; however, clinical studies are rare and observational studies are inconclusive, even though a trend towards an advantage for females has been shown. Nonetheless, further clinical studies are needed as estrogen administration is simple and a single-dose administration of this hormone is not expected to produce any adverse effects. Thus, treatment of traumatized patients with estrogen could prove to be a simple, yet powerful, therapeutic option which may find its way into programs for the management and care of the traumatized host.

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A burning issue: do sepsis and systemic inflammatory response syndrome (SIRS) directly contribute to cardiac dysfunction?

Cited by 59 publications

References 65 publications

Pathophysiology of Sepsis-Related Cardiac Dysfunction: Driven by Inflammation, Energy Mismanagement, or Both?

Pathophysiology of Sepsis-Related Cardiac Dysfunction: Driven by Inflammation, Energy Mismanagement, or Both?

Age influences inflammatory responses, hemodynamics, and cardiac proteasome activation during acute lung injury

Estrogen and multiple organ dysfunction syndrome in critical illness: From bench to bedside

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