The Association between Pneumococcal Pneumonia and Acute Cardiac Events

Abstract

Patients with pneumococcal pneumonia are at substantial risk for a concurrent acute cardiac event, such as MI, serious arrhythmia, or new or worsening CHF. This concurrence significantly increases mortality due to pneumonia. Admitting physicians tend to seek a unifying diagnosis, but the frequent coexistence of pneumonia and cardiac events indicates the importance of considering multiple diagnoses.

Pneumolysin Mediates Platelet Activation In Vitro

“…Acute lung injury and multi-organ dysfunction syndrome, as well as acute cardiac events mostly occurring early in the course of CAP, have been identified as being significant contributors to mortality [1][2][3][4][5][6][7]. In the case of pneumococcal CAP, an increasing body of evidence, derived from both clinical and experimental studies, has implicated the major cytolytic, cholesterolbinding, pore-forming protein toxin, pneumolysin (Ply), in the pathogenesis of associated adverse pulmonary and cardiovascular events [8][9][10][11][12][13].…”

Application of the Formula for Rational Antimicrobial Therapy (FRAT) to Community-Acquired Pneumonia

“…Pneumonia can trigger new cardiac events and contributes to acute exacerbations of pre-existing heart conditions [82,83]. It is estimated that half of the elderly hospitalized CAP patients have concurrent heart disease [84], this dual condition significantly increases mortality due to pneumonia [83]. However, there is a tendency among physicians to seek a unifying diagnosis [83], but CAP and cardiac diseases are mutually aggravating conditions [85].…”

“…It is estimated that half of the elderly hospitalized CAP patients have concurrent heart disease [84], this dual condition significantly increases mortality due to pneumonia [83]. However, there is a tendency among physicians to seek a unifying diagnosis [83], but CAP and cardiac diseases are mutually aggravating conditions [85]. Smoking and diabetes are risk factors for heart disease [86].…”

Hubungan Kadar Cardiac Troponin T (cTnT) sebagai Penanda Jejas Miokardium dengan Derajat Pneumonia pada Anak

“…Rasio prevalens menunjukkan bahwa pneumonia berat merupakan faktor risiko terjadinya peningkatan kadar cTnT, yakni anak dengan klinis pneumonia berat memiliki risiko 2,4 kali untuk mengalami jejas miokardium yang ditandai oleh kadar Hipoksemia pada pneumonia menyebabkan ketidakpadupadanan ventilasi perfusi yang akan menurunkan ketersediaan oksigen pada jaringan, termasuk jaringan miokardium. [4][5][6] Kondisi ini menimbulkan beberapa perubahan metabolisme dalam kardiomiosit yang akan diikuti kerusakan/jejas pada sel. 7,8 Pada anak dengan pneumonia, jejas miokardium telah dilaporkan dengan penanda enzim creatinine kinase MB (CKMB) 9 dan pada anak dengan infeksi saluran nafas bawah yang disebabkan oleh Respiratory Syncytial Virus (RSV) dengan menggunakan cardiac troponin T (cTnT) sebagai penanda.…”

“…Pneumonia menyebabkan ketidakpadupadanan ventilasi perfusi yang menimbulkan berkurangnya kadar oksigen dalam darah (hipoksemia). [4][5][6]9 Sebagai jaringan yang bersifat aerobik obligat, miokardium memerlukan ketersediaan oksigen yang cukup untuk menjalankan metabolisme secara normal. Hipoksemia secara langsung memengaruhi metabolisme dalam jaringan miokardium yang melalui berbagai mekanisme, seperti perubahan ekspresi gen miokardiosit, pembentukan oksi da nitrit untuk mempertahankan tonus vaskular dan kontraktilitas jantung, serta disregulasi pembentukan spesies oksigen reaktif (SOR) yang dapat bereaksi langsung terhadap lapisan lipid, protein, dan DNA sel.…”