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Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Pathomechanisms of Myocardial Dysfunction in Sepsis

Author(s): Clara Batista Lorigados, Francisco Garcia Soriano and Csaba Szabo

Volume 10, Issue 3, 2010

Page: [274 - 284] Pages: 11

DOI: 10.2174/187153010791936856

Price: $65

Abstract

Sepsis remains one of the leading causes of death in intensive care units. Progressive cardiovascular failure is an important cause of the mortality. Septic patients with myocardial dysfunction have significantly higher mortality compared with patients without cardiovascular impairment. Myocardial dysfunction in sepsis is characterized by decreased contractility and impaired myocardial compliance. Experimental studies of sepsis showed heterogeneity of microvascular perfusion, as well as impaired myocardial oxygen extraction. The underlying cellular mechanisms include increased neutrophil adhesion to the endothelium, production of reactive free radicals and oxidants, and endothelial dysfunction. Superoxide, nitric oxide and peroxynitrite cardiac formation has been demonstrated in septic hearts, which has been implicated in the pathogenesis of the myocardial depression and cell death in sepsis. Nitric oxide, carbon monoxide and hydrogen sulfide are gaseotransmitters that may exert protective effects in the septic heart.

Keywords: Carbon monoxide, heart, hydrogen sulfide, myocardial depression, nitric oxide, peroxynitrite, sepsis


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