Myocardial Depression in Sepsis and Septic Shock

Kumar, Anand; Parrillo, Joseph E.

doi:10.1007/3-540-30328-6_30

Cited by 4 publications

(4 citation statements)

References 71 publications

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“…Acute infections result in the release of proinflammatory cytokines and the recruitment of proinflammatory macrophages and granulocytes, leading to a severe inflammatory storm which may exaggerate the initial injury [9]. In combination with the increased metabolic demand, this can lead to cardiac depression and either new-onset HF or acute decompensation of chronic HF [10]. Another contributor to cardiac depression could be the coagulation dysfunction induced by the sepsis [11].…”

Section: Exacerbation Of Chronic Hfmentioning

confidence: 99%

Heart failure and COVID-19

Manla²,

et al. 2020

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Heart failure is a common disease state that can be encountered at different stages in the course of a COVID-19 patient presentation. New or existing heart failure in the setting of COVID-19 can present a set of unique challenges that can complicate presentation, management, and prognosis. A careful understanding of the hemodynamic and diagnostic implications is essential for appropriate triage and management of these patients. Abnormal cardiac biomarkers are common in COVID-19 and can stem from a variety of mechanisms that involve the viral entry itself through the ACE2 receptors, direct cardiac injury, increased thrombotic activity, stress cardiomyopathy, and among others. The cytokine storm observed in this pandemic can be a culprit in many of the observed mechanisms and presentations. A correct understanding of the two-way interaction between heart failure medications and the infection as well as the proposed COVID-19 medications and heart failure can result in optimal management. Guideline-directed medical therapy for heart failure should not be interrupted for theoretical concerns but rather based on tolerance and clinical presentation. Initiating specific cardiac or heart failure medications to prevent the infection or mitigate the disease is also not an evidence-based practice at this time. Heart failure patients on advanced therapies including those with heart transplantation will particularly benefit from involving the advanced heart failure team members in the overall management if they contract the virus.

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Section: Exacerbation Of Chronic Hfmentioning

confidence: 99%

Heart failure and COVID-19

Manla²,

et al. 2020

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“…24 Proinflammatory cytokines and recruitment of proinflammatory macrophages and granulocytes in blood stream lead to severe inflammatory storm and in combination with increased metabolic demand may cause cardiac depression and either new onset heart failure or acute decompensation of chronic heart failure. 25 Viral infections have been shown as one of the most common infectious causes of myocarditis and pericarditis. In spite of widely reported myocarditis cases due to SARS-CoV-2, limited data have been published on cases with COVID-19 who developed pericarditis and pericardial effusion.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the N-Terminal pro-Brain Natriuretic Peptide Levels, Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratios Between the Patients with COVID-19 and Healthy Subjects; Are the Patients with COVID-19 Under the Risk of Cardiovascular Events?

Altınbaş

Aö

et al. 2021

Preprint

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Backround: The ongoing pandemic of Coronavirus Disease 2019 (COVID-19) infection has declared as a global emergency. Although the most people had mild illness due to the infection, some patients were seriously affected associated with complications especially including respiratory and cardiovascular systems. In despite of the respiratory system involvement is in the foreground, cardiovascular complications result in worse clinical outcomes. The purpose of this study is to compare the levels of the N-terminal pro-brain natriuretic peptide, neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratios -which are accepted as a marker of negative outcomes in cardiovascular diseases- of the patients with COVID-19 and healthy subjects and reveal the increased risk of cardiovascular disease in patients with COVID-19. Methods: This prospective study was designed in a single center and included 33 patients with COVID-19 (Group 1) and 33 healthy subjects consisted of health care professionals (Group 2). N-terminal pro-brain natriuretic peptide levels, neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratios were compared between the groups. Results: N-terminal pro-brain natriuretic peptide levels, neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were statistically significantly higher in the patients with COVID-19 (p<0,0001) and lymphocyte-to-monocyte ratio was statistically significantly lower in the same group (p<0,0001). Conclusion: Cardiovascular manifestations result in worse outcomes in patients with COVID-19 although the disease primarily affects the respiratory system. Early detection of this clinical situation and taking precautions have vital importance in the progress of the disease. NT-proBNP levels, neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratios are inexpensive, easy, fast and reproducible parameters that can be used in determination of probabl cardiovascular events that may develop during COVID-19 and enables early optimal treatment strategies for patients.

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“…Cardiac dysfunction can present as systolic and/or diastolic dysfunction. The circulating myocardial depressant substances, which contain different types of cytokines, are responsible for this situation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of early myocardial dysfunction with strain echocardiography in chronic hepatitis B patients

et al. 2019

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Introduction It is well known that chronic hepatitis B virus infection (CHBV) can be associated with cirrhosis and hepatocellular carcinoma but it can also be associated with extra‐hepatic effects, of which cardiac manifestations are the one of the least known. There is a limited amount of data about myocardial dysfunction in CHBV and insufficient data of strain echocardiography in CHBV. The aim of this study was to detect early myocardial dysfunction in CHBV using strain echocardiography. Method This prospective study included 40 CHBV patients without anti‐viral treatment, 40 CHBV patients under anti‐viral treatment, and 40 healthy volunteers as control group from 2017 October to 2018 May. The patients in all groups were aged 30–60 years, with no co‐morbid diseases. Any patients with pathologies that would cause myocardial dysfunction were excluded from the study. All patients were evaluated with transthoracic two‐dimensional (2D), tissue Doppler, and strain echocardiography. Results The mean age and gender distribution were similar in all groups (P = 0.677). A statistically significant difference was determined between the groups in respect of the global circumferential strain and global longitudinal strain values (P < 0.01). The difference in the mean lateral s′ was of statistical significance between the CHBV patients and the control group (P = 0.035). No statistically significant difference was determined in respect of the other echocardiographic parameters. Conclusion As it is a chronic necro‐inflammatory period, chronic HBV can affect myocardial functions. Traditional echocardiographic parameters may not be useful in the detection of early myocardial dysfunction. The results of this study showed that strain echocardiography may be more valuable in early myocardial dysfunction rather than routine 2D echocardiography in CHBV patients.

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Myocardial Depression in Sepsis and Septic Shock

Cited by 4 publications

References 71 publications

Heart failure and COVID-19

Heart failure and COVID-19

Comparison of the N-Terminal pro-Brain Natriuretic Peptide Levels, Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratios Between the Patients with COVID-19 and Healthy Subjects; Are the Patients with COVID-19 Under the Risk of Cardiovascular Events?

Evaluation of early myocardial dysfunction with strain echocardiography in chronic hepatitis B patients

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