Myocardial Cell Injury in Septic Shock

Cardiovascular Aspects of Septic Shock

“…34,37,38 Although damage to myocardial cells (as indicated by increased troponin levels) may occur, myocardial depression is not primarily caused by altered coronary perfusion or global ischemia, but rather by myocardial depressant factors. 39,40 These substances, most likely tumor necrosis factor-α and IL-1β, are released as a part of the inflammatory cascade and appear to cause myocardial depression through pathological generation of nitric oxide and cyclic guanosine monophosphate along with altered signal transduction by β-adrenergic receptors. 3,34,36,41 The altered β-adrenergic signal transduction may be due to decreased levels of a cell membrane protein onset of hematologic dysfunction.…”