Heart Dysfunction in Sepsis

Jaramillo, Ricardo

doi:10.1053/j.jvca.2020.07.026

Cited by 26 publications

(24 citation statements)

References 161 publications

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“…Sepsis-induced myocardial dysfunction (SIMD) is a common complication in patients with sepsis. Many studies have shown that approximately 50% of patients with sepsis show signs of myocardial insufficiency, and the repair of myocardial function affects the prognosis of patients with sepsis ( Poveda-Jaramillo, 2021 ). Compared with patients without cardiovascular dysfunction, sepsis patients with myocardial dysfunction have an increased mortality rate (by 3-fold), and these patients usually show myocarditis, abnormal contractility, increased interstitial collagen and mitochondrial damage ( Blanco et al, 2008 ; Alvarez et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Adiponectin Attenuates Lipopolysaccharide-induced Apoptosis by Regulating the Cx43/PI3K/AKT Pathway

et al. 2021

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Cardiomyocyte apoptosis is a crucial factor leading to myocardial dysfunction. Adiponectin (APN) has a cardiomyocyte-protective impact. Studies have shown that the connexin43 (Cx43) and phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT) signaling pathways play an important role in the heart, but whether APN plays a protective role by regulating these pathways is unclear. Our study aimed to confirm whether APN protects against lipopolysaccharide (LPS)-induced cardiomyocyte apoptosis and to explore whether it plays an important role through regulating the Cx43 and PI3K/AKT signaling pathways. In addition, our research aimed to explore the relationship between the Cx43 and PI3K/AKT signaling pathways. In vitro experiments: Before H9c2 cells were treated with LPS for 24 h, they were pre-treated with APN for 2 h. The cytotoxic effect of APN on H9c2 cells was evaluated by a CCK-8 assay. The protein levels of Bax, Bcl2, cleaved caspase-3, cleaved caspase-9, Cx43, PI3K, p-PI3K, AKT and p-AKT were evaluated by Western blot analysis, and the apoptosis rate was evaluated by flow cytometry. APN attenuated the cytotoxicity induced by LPS. LPS upregulated Bax, cleaved caspase-3 and cleaved caspase-9 and downregulated Bcl2 in H9c2 cells; however, these effects were attenuated by APN. In addition, LPS upregulated Cx43 expression, and APN downregulated Cx43 expression and activated the PI3K/AKT signaling pathway. LPS induced apoptosis and inhibited PI3K/AKT signaling pathway in H9c2 cells, and these effects were attenuated by Gap26 (a Cx43 inhibitor). Moreover, the preservation of APN expression was reversed by LY294002 (a PI3K/AKT signaling pathway inhibitor). In vivo experiments: In C57BL/6J mice, a sepsis model was established by intraperitoneal injection of LPS, and APN was injected into enterocoelia. The protein levels of Bax, Bcl2, cleaved caspase-3, and Cx43 were evaluated by Western blot analysis, and immunohistochemistry was used to detect Cx43 expression and localization in myocardial tissue. LPS upregulated Bax and cleaved caspase-3 and downregulated Bcl2 in sepsis; however, these effects were attenuated by APN. In addition, the expression of Cx43 was upregulated in septic myocardial tissue, and APN downregulated Cx43 expression in septic myocardial tissue. In conclusion, both in vitro and in vivo, the data demonstrated that APN can protect against LPS-induced apoptosis during sepsis by modifying the Cx43 and PI3K/AKT signaling pathways.

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Section: Introductionmentioning

confidence: 99%

Adiponectin Attenuates Lipopolysaccharide-induced Apoptosis by Regulating the Cx43/PI3K/AKT Pathway

et al. 2021

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“…BNP also has prognostic value in sepsis (14,15). Some studies have already assessed diastolic function in SICM (4,16,17). A reduced e wave (e' <8 cm/s) and an increased E/e' ratio are common findings in patients with sepsis and are strong predictors of diastolic cardiac dysfunction in septic shock (18).…”

Section: Discussionmentioning

confidence: 99%

“…Standard early goal- directed therapy includes vasopressors, inotropes, and fluid resuscitation (30 mL/kg bolus of crystalloid fluid administration within 3 hours of sepsis presentation to correct hypotension). However, fluid resuscitation and vasopressors may not always be sufficient to reverse cardiac dysfunction in patients with SICM, and unfortunately, excessive volume or afterload by fluid resuscitation may exacerbate mortality in SICM (4,26).…”

Section: Discussionmentioning

confidence: 99%

“…Supportive care, such as invasive positive pressure ventilation and continuous renal replacement therapy, can be prescribed to improve cardiac function and control systemic inflammatory response. Also, extracorporeal membrane oxygenation may be able to provide hemodynamic rescue for patients who are critically ill with SICM (4,27).…”

Section: Discussionmentioning

confidence: 99%

“…Most experts agree that characteristics of SICM include acute and reversible cardiac dysfunction within 7 to 10 days after sepsis, with left ventricular dilation, global dysfunction, or reduced contractility. Patients with SICM rely on catecholamines and have diminished responses to fluid resuscitation (4). In this single-center study, we retrospectively analyzed data of patients who had developed postoperative SICM after undergoing general thoracic surgical procedures (in the lung, esophagus, trachea, and mediastinum) between 2018 and 2019.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for postoperative sepsis-induced cardiomyopathy in patients undergoing general thoracic surgery: a single center experience

et al. 2021

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Background: The current study aimed to investigate the incidence of sepsis-induced cardiomyopathy (SICM) in patients who received general thoracic surgery, along with the risk factors and management strategies for this complication. Methods: The clinical records of 163 patients with postoperative sepsis were retrospectively reviewed. After propensity score matching, 144 patients were divided into 2 groups by stroke volume: the SICM group (n=72) and the non-SICM group (n=72). Results: The overall incidence of postoperative SICM was 53.99%. Multiple logistic regression analysis showed that stroke volume and C-reactive protein were independent predictors of mortality in patients with postoperative sepsis. Statistical analysis by t-test and χ 2 test indicated that mortality (P=0.000), B-type natriuretic peptide (P=0.001), left ventricular ejection fraction (P=0.000), the mitral peak velocity of early filling/early diastolic mitral annular velocity (E/e') (P=0.049), C-reactive protein (P=0.016), procalcitonin (P=0.013), serum creatinine (P=0.016), platelets (P=0.028), and lactic acid (P=0.002) were significantly associated with the occurrence of postoperative SICM. Among these parameters, B-type natriuretic peptide was identified as the best biomarker for predicting SICM by receiver operating characteristic (ROC) curve analysis. Conclusions: It is vital to improve the diagnosis and standard management of SICM. A combined strategy comprising early detection of suspected infection, adequate use of antibiotics, close monitoring, effective drainage, and supportive care may improve the outcomes of patients with postoperative SICM.

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Apelin ameliorates sepsis-induced myocardial dysfunction via inhibition of NLRP3-mediated pyroptosis of cardiomyocytes

Cao,

Li,

Shao

et al. 2024

Heliyon

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Heart Dysfunction in Sepsis

Cited by 26 publications

References 161 publications

Adiponectin Attenuates Lipopolysaccharide-induced Apoptosis by Regulating the Cx43/PI3K/AKT Pathway

Adiponectin Attenuates Lipopolysaccharide-induced Apoptosis by Regulating the Cx43/PI3K/AKT Pathway

Risk factors for postoperative sepsis-induced cardiomyopathy in patients undergoing general thoracic surgery: a single center experience

Apelin ameliorates sepsis-induced myocardial dysfunction via inhibition of NLRP3-mediated pyroptosis of cardiomyocytes

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