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Na SJ, Ko RE, Chung CR, Yang JH, Oh DK, Lee SY, Park MH, Lee H, Lim CM, Suh GY. Early detection of low QRS voltage and its association with mortality in patients with sepsis. Sci Rep 2024; 14:16066. [PMID: 38992092 PMCID: PMC11239899 DOI: 10.1038/s41598-024-66612-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024] Open
Abstract
Various electrocardiographic changes occur during sepsis, but data on the clinical importance of a low QRS voltage in sepsis are still limited. We aimed to evaluate the association between low QRS voltage identified early in sepsis and mortality in patients with sepsis. Between September 2019 and December 2020, all consecutive adult patients diagnosed with sepsis in the emergency room or general ward at Samsung Medical Center were enrolled. Patients without a 12-lead electrocardiogram recorded within 48 h of recognition of sepsis were excluded. In 432 eligible patients, 12-lead electrocardiogram was recorded within the median of 24 min from the first recognition of sepsis, and low QRS voltage was identified in 115 (26.6%) patients. The low QRS group showed more severe organ dysfunction and had higher levels of N-terminal pro-brain natriuretic peptide. The hospital mortality was significantly higher in the low QRS voltage group than in the normal QRS voltage group (49.6% vs. 28.1%, p < 0.001). Similarly, among the 160 patients who required intensive care unit admission, significantly more patients in the low QRS group died in the intensive care unit (35.9% vs. 18.2%, p = 0.021). Low QRS voltage was associated with increased hospital mortality in patients with sepsis.
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Affiliation(s)
- Soo Jin Na
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ryoung-Eun Ko
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chi Ryang Chung
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Hoon Yang
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Kyu Oh
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Su Yeon Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi Hyeon Park
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Haein Lee
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chae-Man Lim
- Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Gee Young Suh
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Kumar N, Pestrak MJ, Wu Q, Ahumada OS, Dellos-Nolan S, Saljoughian N, Shukla RK, Mitchem CF, Nagareddy PR, Ganesan LP, William LP, Wozniak DJ, Rajaram MVS. Pseudomonas aeruginosa pulmonary infection results in S100A8/A9-dependent cardiac dysfunction. PLoS Pathog 2023; 19:e1011573. [PMID: 37624851 PMCID: PMC10484443 DOI: 10.1371/journal.ppat.1011573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/07/2023] [Accepted: 07/22/2023] [Indexed: 08/27/2023] Open
Abstract
Pseudomonas aeruginosa (P.a.) infection accounts for nearly 20% of all cases of hospital acquired pneumonia with mortality rates >30%. P.a. infection induces a robust inflammatory response, which ideally enhances bacterial clearance. Unfortunately, excessive inflammation can also have negative effects, and often leads to cardiac dysfunction with associated morbidity and mortality. However, it remains unclear how P.a. lung infection causes cardiac dysfunction. Using a murine pneumonia model, we found that P.a. infection of the lungs led to severe cardiac left ventricular dysfunction and electrical abnormalities. More specifically, we found that neutrophil recruitment and release of S100A8/A9 in the lungs activates the TLR4/RAGE signaling pathways, which in turn enhance systemic inflammation and subsequent cardiac dysfunction. Paradoxically, global deletion of S100A8/A9 did not improve but aggravated cardiac dysfunction and mortality likely due to uncontrolled bacterial burden in the lungs and heart. Our results indicate that P.a. infection induced release of S100A8/9 is double-edged, providing increased risk for cardiac dysfunction yet limiting P.a. growth.
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Affiliation(s)
- Naresh Kumar
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Matthew J. Pestrak
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Qian Wu
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Omar Santiagonunez Ahumada
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Sheri Dellos-Nolan
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Noushin Saljoughian
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Rajni Kant Shukla
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Cortney F. Mitchem
- Department of Microbiology, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Prabhakara R. Nagareddy
- Department of Surgery, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Latha P. Ganesan
- Department of Internal Medicine, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Lafuse P. William
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Daniel J. Wozniak
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
- Department of Microbiology, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
| | - Murugesan V. S. Rajaram
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio, United States of America
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Kluckner M, Enzmann F, Gruber L, Wipper SH, Bonaros N, Schachner T. Risk of Permanent Pacemaker Implantation Following Bentall Operation. Semin Thorac Cardiovasc Surg 2022; 35:639-646. [PMID: 35709882 DOI: 10.1053/j.semtcvs.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/11/2022]
Abstract
Conduction disorders following cardiac surgery are common complications with incidences of permanent pacemaker dependency up to 5%. However, data on pacemaker implantation rates in the long-term follow-up after Bentall operations are scarce. In a retrospective study, a mixed cohort of 260 patients including endocarditis and aortic dissection undergoing Bentall operation between March 1996 and December 2015 was analyzed. Median follow-up time was 60 (12-107) months. Early and late rates of permanent pacemaker implantation and associated risk factors were investigated. In the postoperative course 31 (11.9%) permanent pacemakers were implanted. The 30-day incidence of pacemaker implantations was 7.7% with operations performed after a median of 6 (3-12) days after the Bentall operation. After ten years, 21% of the Bentall patients were permanent pacemaker dependent. The risk factors for permanent pacemaker dependency included age above 75 years (16.1% vs 5.7%; P < 0.001), preoperative cardiac conduction disturbance (32.3% vs 22.7%, P = 0.018), aortic valve stenosis (38.7% vs 23.1, P = 0.008), infective endocarditis (19.4% vs 7.4%, P = 0.004), tricuspid valve reconstruction (6.5% vs 0.9%, P = 0.033), sepsis (12.9% vs 4.4%, P < 0.001) and non-cardiac reoperation (19.4% vs 8.7%, P = 0.004). Pacemaker implantation significantly increased the length of initial hospitalization (13 [8-26] days vs 8 [7-13] days; P = 0.003). In the long-term follow-up, mortality was not different between the groups. Permanent pacemaker dependency is a frequent complication in the short- and long-term follow-up after Bentall operations. Screening for cardiac conduction disturbances in the short- and long-term follow-up is recommended.
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Affiliation(s)
- Michaela Kluckner
- Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Florian Enzmann
- Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Leonhard Gruber
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Sabine Helena Wipper
- Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Nikolaos Bonaros
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Thomas Schachner
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria.
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Esfahani NS, Wu Q, Kumar N, Ganesan LP, Lafuse WP, Rajaram MVS. Aging influences the cardiac macrophage phenotype and function during steady state and during inflammation. Aging Cell 2021; 20:e13438. [PMID: 34342127 PMCID: PMC8373275 DOI: 10.1111/acel.13438] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/14/2021] [Accepted: 07/03/2021] [Indexed: 12/16/2022] Open
Abstract
Aging‐mediated immune dysregulation affects the normal cardiac immune cell phenotypes and functions, resulting in cardiac distress. During cardiac inflammation, immune activation is critical for mounting the regenerative responses to maintain normal heart function. We investigated the impact of aging on myeloid cell phenotype and function during cardiac inflammation induced by a sub‐lethal dose of LPS. Our data show that hearts of old mice contain more myeloid cells than the hearts of young mice. However, while the number of monocytic‐derived suppressor cells did not differ between young and old mice, monocytic‐derived suppressor cells from old mice were less able to suppress T‐cell proliferation. Since cardiac resident macrophages (CRMs) are important for immune surveillance, clearance of dead cells, and tissue repair, we focused our studies on CRMs phenotype and function during steady state and LPS treatment. In the steady state, we observed significantly more MHC‐IIlow and MHC‐IIhigh CRMs in the hearts of old mice; however, these populations were decreased in both young and aged mice upon LPS treatment and the decrease in CRM populations correlated with defects in cardiac electrical activity. Notably, mice treated with a liver X receptor (LXR) agonist showed an increase in MerTK expression in CRMs of both young and old mice, which resulted in the reversal of cardiac electrical dysfunction caused by lipopolysaccharide (LPS). We conclude that aging alters the phenotype of CRMs, which contributes to the dysregulation of cardiac electrical dysfunction during infection in aged mice.
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Affiliation(s)
- Noushin Saljoughian Esfahani
- Department of Microbial Infection and Immunity/ College of Medicine The Ohio State University Wexner Medical Center Columbus OH USA
| | - Qian Wu
- Department of Microbial Infection and Immunity/ College of Medicine The Ohio State University Wexner Medical Center Columbus OH USA
| | - Naresh Kumar
- Department of Microbial Infection and Immunity/ College of Medicine The Ohio State University Wexner Medical Center Columbus OH USA
| | - Latha Prabha Ganesan
- Department of Internal Medicine College of Medicine The Ohio State UniversityWexner Medical Center Columbus OH USA
| | - William P. Lafuse
- Department of Microbial Infection and Immunity/ College of Medicine The Ohio State University Wexner Medical Center Columbus OH USA
| | - Murugesan V. S. Rajaram
- Department of Microbial Infection and Immunity/ College of Medicine The Ohio State University Wexner Medical Center Columbus OH USA
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Li C, Liu Y, Qin J, Liu Y, Ma L, Zhang S, Wang J, Wang S. Profiles of differentially expressed long noncoding RNAs and messenger RNAs in the myocardium of septic mice. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:199. [PMID: 33708826 PMCID: PMC7940873 DOI: 10.21037/atm-20-3830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Sepsis is the primary cause of mortality in the intensive care unit (ICU), mainly due to sepsis-induced dysfunction of essential organs such as the heart and lungs. This study investigated the myocardium's epigenetic characterization from septic mice to identify potential treatment targets for septic myocardial dysfunction. Methods Cecal ligation and puncture (CLP) was used to induce sepsis in male C57BL/6 mice. Hearts were collected 24 h after surgery to determine the expression profiles of long noncoding RNAs (lncRNAs) and messenger RNAs (mRNAs) by microarray. To validate the reliability of microarray results, we randomly chose six differentially expressed lncRNAs for qRT-PCR. Functional mapping of differentially expressed mRNAs was annotated with gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses; lncRNA-mRNA co-expression network was constructed to reveal connections between lncRNAs and mRNAs. Results Microarray analysis indicated that 1,568 lncRNAs and 2,166 mRNAs were differentially expressed in the myocardium from septic mice, which was further confirmed by qRT-PCR. KEGG pathway analysis showed that numerous differentially expressed mRNAs were relevant to tumor necrosis factor (TNF) and phosphatidylinositol-3-kinase/protein kinase B (PI3K/Akt) signaling pathways. Moreover, according to the lncRNA-mRNA co-expression network constructed by the above six lncRNAs and their interacting mRNAs, the co-expression network profiles had 57 network nodes and 134 connections, including 76 positive interactions and 58 negative interactions. Conclusions In mouse hearts, sepsis resulted in differential expression of lncRNAs and mRNAs related to TNF and PI3K-Akt signaling pathways, suggesting that lncRNAs and their interacting mRNAs may participate in the pathogenesis of septic myocardial dysfunction by regulating TNF and PI3K-Akt signaling pathways.
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Affiliation(s)
- Chengbao Li
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yongchao Liu
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jing Qin
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yuhao Liu
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Lijie Ma
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Shouqin Zhang
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Junjie Wang
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Sheng Wang
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
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6
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Rethinking animal models of sepsis - working towards improved clinical translation whilst integrating the 3Rs. Clin Sci (Lond) 2021; 134:1715-1734. [PMID: 32648582 PMCID: PMC7352061 DOI: 10.1042/cs20200679] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/13/2022]
Abstract
Sepsis is a major worldwide healthcare issue with unmet clinical need. Despite extensive animal research in this area, successful clinical translation has been largely unsuccessful. We propose one reason for this is that, sometimes, the experimental question is misdirected or unrealistic expectations are being made of the animal model. As sepsis models can lead to a rapid and substantial suffering – it is essential that we continually review experimental approaches and undertake a full harm:benefit impact assessment for each study. In some instances, this may require refinement of existing sepsis models. In other cases, it may be replacement to a different experimental system altogether, answering a mechanistic question whilst aligning with the principles of reduction, refinement and replacement (3Rs). We discuss making better use of patient data to identify potentially useful therapeutic targets which can subsequently be validated in preclinical systems. This may be achieved through greater use of construct validity models, from which mechanistic conclusions are drawn. We argue that such models could provide equally useful scientific data as face validity models, but with an improved 3Rs impact. Indeed, construct validity models may not require sepsis to be modelled, per se. We propose that approaches that could support and refine clinical translation of research findings, whilst reducing the overall welfare burden on research animals.
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Wang Y, Zhang X, Guo Y, Li X, Guo G, Niu Z, Zhang J. Type 1 interferon aggravates lipopolysaccharide-induced sepsis through upregulating Caspase-11 and Gasdermin D. J Physiol Biochem 2021; 77:85-92. [PMID: 33515436 DOI: 10.1007/s13105-021-00785-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/07/2021] [Indexed: 12/20/2022]
Abstract
This study aimed to investigate the mechanism of type I interferon (IFN) in aggravating sepsis in bacterial infection, focusing on the roles of Caspase-11 (Casp11) and Gasdermin D (Gsdmd) in this process. Type I interferons, including IFNα and IFNβ, were used to treat peritoneal macrophage harvested from wild-type or IFNα/βR1 knockout (KO) mice, of which the levels of Casp11 and Gsdmd were monitored using real-time polymerase chain reaction (RT-PCR) and Western blot, the exposure to phosphatidylserine was monitored by flow cytometry, and tissue factor (TF) activation was assessed by RT-PCR and TF chromogenic assay. Endotoxemia in wild-type mice led to upregulation of Casp11 and Gsdmd in myeloid cells, which in contrast was attenuated in IFNα/βR1 KO mice. IFNα or IFNβ treatment led to dose-dependent upregulation of Casp11 and Gsdmd in peritoneal macrophages harvested from wild-type mice, but induced negligible changes in IFNα/βR1 KO mice. Type I IFN promoted phosphatidylserine exposure in peritoneal macrophage from wild-type mice but not IFNα/βR1 KO mice. Type I IFN induced insignificant changes of TF expression levels in both wild-type mice and IFNα/βR1 KO mice, but the TF activity was markedly increased in wild-type mice after type I IFN treatment. Our data suggested that the upregulation of Casp11 and Gsdmd in myeloid cells and macrophages induced by endotoxemia was reliant on the expression of IFNα/βR1. IFNα or IFNβ treatment efficiently upregulated Casp11 and Gsdmd, phosphatidylserine exposure, and TF activity of macrophages. Therefore, type I IFN could aggravate sepsis through upregulating Casp11 and Gsdmd.
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Affiliation(s)
- Yan Wang
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, No. 215, Hepingxi Road, Shijiazhuang, 050000, Hebei, China
| | - Xiaolei Zhang
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, No. 215, Hepingxi Road, Shijiazhuang, 050000, Hebei, China
| | - Yujie Guo
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, No. 215, Hepingxi Road, Shijiazhuang, 050000, Hebei, China
| | - Xiao Li
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, No. 215, Hepingxi Road, Shijiazhuang, 050000, Hebei, China
| | - Guanyi Guo
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, No. 215, Hepingxi Road, Shijiazhuang, 050000, Hebei, China
| | - Zhiyun Niu
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, No. 215, Hepingxi Road, Shijiazhuang, 050000, Hebei, China
| | - Jingyu Zhang
- Department of Hematology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Hematology, No. 215, Hepingxi Road, Shijiazhuang, 050000, Hebei, China.
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Lafuse WP, Wozniak DJ, Rajaram MVS. Role of Cardiac Macrophages on Cardiac Inflammation, Fibrosis and Tissue Repair. Cells 2020; 10:E51. [PMID: 33396359 PMCID: PMC7824389 DOI: 10.3390/cells10010051] [Citation(s) in RCA: 175] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 12/17/2022] Open
Abstract
The immune system plays a pivotal role in the initiation, development and resolution of inflammation following insult or damage to organs. The heart is a vital organ which supplies nutrients and oxygen to all parts of the body. Heart failure (HF) has been conventionally described as a disease associated with cardiac tissue damage caused by systemic inflammation, arrhythmia and conduction defects. Cardiac inflammation and subsequent tissue damage is orchestrated by the infiltration and activation of various immune cells including neutrophils, monocytes, macrophages, eosinophils, mast cells, natural killer cells, and T and B cells into the myocardium. After tissue injury, monocytes and tissue-resident macrophages undergo marked phenotypic and functional changes, and function as key regulators of tissue repair, regeneration and fibrosis. Disturbance in resident macrophage functions such as uncontrolled production of inflammatory cytokines, growth factors and inefficient generation of an anti-inflammatory response or unsuccessful communication between macrophages and epithelial and endothelial cells and fibroblasts can lead to aberrant repair, persistent injury, and HF. Therefore, in this review, we discuss the role of cardiac macrophages on cardiac inflammation, tissue repair, regeneration and fibrosis.
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Affiliation(s)
- William P. Lafuse
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH 43210, USA; (W.P.L.); (D.J.W.)
| | - Daniel J. Wozniak
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH 43210, USA; (W.P.L.); (D.J.W.)
- Department of Microbiology, Ohio State University, Columbus, OH 43210, USA
| | - Murugesan V. S. Rajaram
- Department of Microbial Infection and Immunity, College of Medicine, Ohio State University, Columbus, OH 43210, USA; (W.P.L.); (D.J.W.)
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Affiliation(s)
- Armand O. Brown
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- * E-mail: (AOB); (DAG)
| | - Danielle A. Garsin
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- * E-mail: (AOB); (DAG)
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10
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Brown AO, Singh KV, Cruz MR, Kaval KG, Francisco LE, Murray BE, Garsin DA. Cardiac Microlesions Form During Severe Bacteremic Enterococcus faecalis Infection. J Infect Dis 2020; 223:508-516. [PMID: 32597945 DOI: 10.1093/infdis/jiaa371] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/22/2020] [Indexed: 12/22/2022] Open
Abstract
Enterococcus faecalis is a significant cause of hospital-acquired bacteremia. Herein, the discovery is reported that cardiac microlesions form during severe bacteremic E. faecalis infection in mice. The cardiac microlesions were identical in appearance to those formed by Streptococcus pneumoniae during invasive pneumococcal disease. However, E. faecalis does not encode the virulence determinants implicated in pneumococcal microlesion formation. Rather, disulfide bond forming protein A (DsbA) was found to be required for E. faecalis virulence in a Caenorhabditis elegans model and was necessary for efficient cardiac microlesion formation. Furthermore, E. faecalis promoted cardiomyocyte apoptotic and necroptotic cell death at sites of microlesion formation. Additionally, loss of DsbA caused an increase in proinflammatory cytokines, unlike the wild-type strain, which suppressed the immune response. In conclusion, we establish that E. faecalis is capable of forming cardiac microlesions and identify features of both the bacterium and the host response that are mechanistically involved.
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Affiliation(s)
- Armand O Brown
- Department of Microbiology and Molecular Genetics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kavindra V Singh
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Melissa R Cruz
- Department of Microbiology and Molecular Genetics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Karan Gautam Kaval
- Department of Microbiology and Molecular Genetics, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Liezl E Francisco
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Barbara E Murray
- Department of Microbiology and Molecular Genetics, University of Texas Health Science Center at Houston, Houston, Texas, USA.,Division of Infectious Diseases, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Danielle A Garsin
- Department of Microbiology and Molecular Genetics, University of Texas Health Science Center at Houston, Houston, Texas, USA
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11
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Zhou MQ, Jin E, Wu J, Ren F, Yang YZ, Duan DD. CTRP12 Ameliorated Lipopolysaccharide-Induced Cardiomyocyte Injury. Chem Pharm Bull (Tokyo) 2020; 68:133-139. [PMID: 32009080 DOI: 10.1248/cpb.c19-00646] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
C1q/tumor necrosis factor (TNF)-related protein 12 (CTRP12) is a secretory protein that participates in the regulation of glucose and lipid metabolism in obesity and diabetes. Its role in cardiovascular disease, particularly sepsis-induced cardiac injury, is unclear. Here, we stimulated cardiomyocytes with lipopolysaccharide (LPS) to establish an in vitro cardiomyocyte injury model and CTRP12 was overexpressed with an adenovirus delivery system. Overexpression of CTRP12 reduced the transcription and release of pro-inflammatory cytokines from LPS-stimulated cardiomyocytes, including TNFα, interleukin-1 (IL-1), and IL-6. Reactive oxygen species (ROS) level increased and the oxidation/redox system was disturbed in LPS-stimulated cardiomyocytes, as evident from the decrease in superoxide dismutase activity and an increase in reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity and malondialdehyde level. CTRP12 overexpression decreased the increasing level of ROS and ameliorated the unbalance in the oxidation/redox system in LPS-stimulated cardiomyocytes. The viability of cardiomyocytes decreased after LPS stimulation, and the cells underwent apoptosis. CTRP12-overexpressing cardiomyocytes showed a decrease in the number of terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL)-positive cells, and the ratio of B cell lymphoma (Bcl)-1/Bax in these cells was recovered. In comparison with the control group, LPS-stimulated cardiomyocytes showed reduced expression of nuclear factor E2-related factor 2 (NRF2), while CTRP12-overexpressing cardiomyocytes showed elevated NRF2 expression. Small-interfering RNA-mediated silencing of NRF2 expression in cardiomyocytes resulted in the inhibition of the protective effects of CTRP12. Thus, CTRP12 ameliorated injury in LPS-stimulated cardiomyocytes in an NRF2-dependent manner.
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Affiliation(s)
- Meng-Qiao Zhou
- Cardiology Function Examination Room, The First People's Hospital of Jingmen
| | - E Jin
- Cardiology Function Examination Room, The First People's Hospital of Jingmen
| | - Jing Wu
- Department of Cardiology, The First People's Hospital of Jingmen
| | - Fei Ren
- Department of Cardiology, The First People's Hospital of Jingmen
| | - Yu-Zhi Yang
- Department of Orthopaedic Surgery, The First People's Hospital of Jingmen
| | - Dong-Dong Duan
- Department of Orthopaedic Surgery, The First People's Hospital of Jingmen
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Ahmed S, Ahmed N, Rungatscher A, Linardi D, Kulsoom B, Innamorati G, Meo SA, Gebrie MA, Mani R, Merigo F, Guzzo F, Faggian G. Cocoa Flavonoids Reduce Inflammation and Oxidative Stress in a Myocardial Ischemia-Reperfusion Experimental Model. Antioxidants (Basel) 2020; 9:antiox9020167. [PMID: 32085604 PMCID: PMC7070606 DOI: 10.3390/antiox9020167] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 12/13/2022] Open
Abstract
: Consumption of flavonoid-rich nutraceuticals has been associated with a reduction in coronary events. The present study analyzed the effects of cocoa flavonols on myocardial injury following acute coronary ischemia-reperfusion (I/R). A commercially available cocoa extract was identified by chromatographic mass spectrometry. Nineteen different phenolic compounds were identified and 250 mg of flavan-3-ols (procyanidin) were isolated in 1 g of extract. Oral administration of cocoa extract in incremental doses from 5 mg/kg up to 25 mg/kg daily for 15 days in Sprague Dawley rats (n = 30) produced a corresponding increase of blood serum polyphenols and become constant after 15 mg/kg. Consequently, the selected dose (15 mg/kg) of cocoa extract was administered orally daily for 15 days in a treated group (n = 10) and an untreated group served as control (n = 10). Both groups underwent surgical occlusion of the left anterior descending coronary artery and reperfusion. Cocoa extract treatment significantly reversed membrane peroxidation, nitro-oxidative stress, and decreased inflammatory markers (IL-6 and NF-kB) caused by myocardial I/R injury and enhanced activation of both p-Akt and p-Erk1/2. Daily administration of cocoa extract in rats is protective against myocardial I/R injury and attenuate nitro-oxidative stress, inflammation, and mitigates myocardial apoptosis.
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Affiliation(s)
- Sajeela Ahmed
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
| | - Naseer Ahmed
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
- Department of Biological and Biomedical Sciences, Aga Khan University, 74800 Karachi, Pakistan
| | - Alessio Rungatscher
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
- Correspondence:
| | - Daniele Linardi
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
| | - Bibi Kulsoom
- Department of Biochemistry, Jinnah Medical & Dental College, 74800 Karachi, Pakistan
| | - Giulio Innamorati
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
| | - Sultan Ayoub Meo
- Department of Physiology, College of Medicine, King Saud University, 11461 Riyadh, Saudi Arabia
| | - Mebratu Alebachew Gebrie
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
| | - Romel Mani
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
| | - Flavia Merigo
- Department of Biomedicine, Division of Histology, University of Verona, 37134 Verona, Italy
| | - Flavia Guzzo
- Department of Biotechnology, Division of Biology and Botany, University of Verona, 37134 Verona, Italy
| | - Giuseppe Faggian
- Department of Surgery, Division of Cardiac Surgery, University of Verona, 37129 Verona, Italy (N.A.)
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Lin SP, Tu C, Huang W, Wu Y, Lin PY, Ye S, Long Y, Xu W, Chen S, Wen YS, Ou Y, Li X, Chen XH. Acute-phase serum superoxide dismutase level as a predictive biomarker for stroke-associated infection. Int J Neurosci 2019; 130:186-192. [PMID: 31696761 DOI: 10.1080/00207454.2019.1667790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background and Purpose: Oxidative stress is involved in the development of infections. However, whether oxidative stress indicators can be used as markers of stroke-associated infection (SAI) is still unclear. The purpose of this study was to test the predictive values of superoxide dismutase (SOD) and malondialdehyde (MDA) levels for SAI incidence.Methods: A total of 45 consecutive patients with ischemic stroke who were admitted to our hospital were enrolled. A prospective study was carried out to observe the occurrence of SAI during the first 7 days after stroke. Accordingly, the patients were divided into SAI and non-SAI groups. The relationship between SOD and MDA serum levels and SAI was analyzed.Results: The patients in the SAI group had significantly higher serum SOD levels than those in the non-SAI group (41.638 ± 3.428 U/ml vs. 36.542 ± 9.114 U/ml, p = 0.033). However, there were no significant differences in MDA levels between the SAI and non-SAI group (p > 0.05). The discriminating ability of serum SOD level for SAI was measured using an ROC curve. Serum level of SOD >38.16 U/ml was useful in diagnosing SAI with a sensitivity of 88% and a specificity of 61%. Kaplan-Meier curves showed that the group with serum SOD level >38.16 U/ml had higher rates of SAI incidence (χ2 = 9.688, p = 0.002; log rank test). Furthermore, Cox regression analysis indicated that a serum SOD level >38.16 U/ml was an independent risk factor for SAI (hazard ratio = 5.836; 95% CI, 1.298-26.244; p = 0.021).Conclusions: Acute-phase serum SOD level could be a predictor of SAI.
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Affiliation(s)
- Shao-Peng Lin
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | | | - Wenyao Huang
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Yi Wu
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Pei-Yi Lin
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Shan Ye
- Department of Geriatrics, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Youming Long
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
| | - Weiqiang Xu
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Shishi Chen
- Guangzhou Medical University, Guangzhou, P.R. China
| | | | - Yongqi Ou
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Xiujin Li
- Guangzhou Medical University, Guangzhou, P.R. China
| | - Xiao-Hui Chen
- Department of Emergency, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, P.R. China
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14
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Headley C, Turner J, Rajaram MV. Aging heart and infection. Aging (Albany NY) 2019; 11:4781-4782. [PMID: 31346150 PMCID: PMC6682520 DOI: 10.18632/aging.102128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Colwyn Headley
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Joanne Turner
- Texas Biomedical Research Institute, San Antonio, TX 78227, USA
| | - Murugesan Vs Rajaram
- Department of Microbial Infection and Immunity, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
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15
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Liu ZJ, Liu H, Wu C, Xue K. Effect of sepsis on the action potential and cardiac serotonin response in rats. Exp Ther Med 2019; 18:2207-2212. [PMID: 31452710 DOI: 10.3892/etm.2019.7810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 05/16/2019] [Indexed: 01/22/2023] Open
Abstract
The current study aimed to investigate the effect of sepsis on rat serotonin (5-HT) responses and cardiac action potentials. A total of 20 rats were randomly divided into a sepsis and control group (each, n=10). Rat hearts were harvested and perfused using the Langendorff method 18-h after the induction of sepsis, which was assessed using cecal puncture. Cardiac action potential was subsequently measured using a multichannel electrophysiology instrument. Immunohistochemistry and quantitative analysis were performed to identify the effect of sepsis on myocardial 5-HT expression. The results revealed that mitochondrial changes were present in septic rat hearts. Heart rate (361.10±12.29 bpm vs. 348.60±12.38 bpm; P<0.05) was significantly higher, atrial action potential duration (106.40±2.95 ms vs. 86.60±4.12 ms; P<0.01) was significantly longer and the area (0.62±0.06 µm2 vs. 0.39±0.05 µm2; P<0.05) and number (0.92±0.02/field vs. 0.46±0.01/field; P<0.01) of myocardial cells were significantly higher in the septic compared with the control group. These results demonstrated that 5-HT prolongs the atrial action potential, increases heart rate and aggravates myocardial injury, indicating that it may therefore be one of the factors that leads to cardiac dysfunction in sepsis.
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Affiliation(s)
- Zheng-Jiang Liu
- Department of Cardiology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, Guangdong 511500, P.R. China
| | - Hua Liu
- Department of Cardiology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, Guangdong 511500, P.R. China
| | - Changdong Wu
- Intensive Medicine Unit, The People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region 830001, P.R. China
| | - Kedong Xue
- Intensive Medicine Unit, The People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region 830001, P.R. China
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16
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Headley CA, Gerberick A, Mehta S, Wu Q, Yu L, Fadda P, Khan M, Ganesan LP, Turner J, Rajaram MVS. Nontuberculous mycobacterium M. avium infection predisposes aged mice to cardiac abnormalities and inflammation. Aging Cell 2019; 18:e12926. [PMID: 30834643 PMCID: PMC6516181 DOI: 10.1111/acel.12926] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/12/2018] [Accepted: 01/20/2019] [Indexed: 12/14/2022] Open
Abstract
Biological aging dynamically alters normal immune and cardiac function, favoring the production of pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and increased instances of cardiac distress. Cardiac failure is the primary reason for hospitalization of the elderly (65+ years). The elderly are also increasingly susceptible to developing chronic bacterial infections due to aging associated immune abnormalities. Since bacterial infections compound the rates of cardiac failure in the elderly, and this phenomenon is not entirely understood, the interplay between the immune system and cardiovascular function in the elderly is of great interest. Using Mycobacterium avium, an opportunistic pathogen, we investigated the effect of mycobacteria on cardiac function in aged mice. Young (2-3 months) and old (18-20 months) C57BL/6 mice were intranasally infected with M. avium strain 104, and we compared the bacterial burden, immune status, cardiac electrical activity, pathology, and function of infected mice against uninfected age-matched controls. Herein, we show that biological aging may predispose old mice infected with M. avium to mycobacterial dissemination into the heart tissue and this leads to cardiac dysfunction. M. avium infected old mice had significant dysrhythmia, cardiac hypertrophy, increased recruitment of CD45+ leukocytes, cardiac fibrosis, and increased expression of inflammatory genes in isolated heart tissue. This is the first study to report the effect of mycobacteria on cardiac function in an aged model. Our findings are critical to understanding how nontuberculous mycobacterium (NTM) and other mycobacterial infections contribute to cardiac dysfunction in the elderly population.
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Affiliation(s)
- Colwyn A. Headley
- Department of Microbial Infection and Immunity, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
- Texas Biomedical Research Institute8715 W. Military Dr.San AntonioTX 78227
| | - Abigail Gerberick
- Department of Microbiology, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
| | - Sumiran Mehta
- Department of Microbiology, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
| | - Qian Wu
- Department of Microbial Infection and Immunity, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
| | - Lianbo Yu
- Department of Biomedical Informatics, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
| | - Paolo Fadda
- Department of Biomedical Informatics, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
- Genomics Shared Resource‐Comprehensive Cancer Center, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
| | - Mahmood Khan
- Department Emergency Medicine & Physiology and Cell Biology, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
| | - Latha Prabha Ganesan
- Department of Internal Medicine, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
| | - Joanne Turner
- Department of Microbial Infection and Immunity, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
- Texas Biomedical Research Institute8715 W. Military Dr.San AntonioTX 78227
| | - Murugesan V. S. Rajaram
- Department of Microbial Infection and Immunity, College of MedicineThe Ohio State University Wexner Medical CenterColumbusOhio
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Wu P, Kong L, Li J. MicroRNA-494-3p protects rat cardiomyocytes against septic shock via PTEN. Exp Ther Med 2018; 17:1706-1716. [PMID: 30783439 PMCID: PMC6364176 DOI: 10.3892/etm.2018.7116] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 07/26/2018] [Indexed: 02/06/2023] Open
Abstract
The aim of the present study was to investigate the role of microRNA (miR)-494-3p in myocardial injury in patients with septic shock and the underlying mechanism. A total of 22 patients with sepsis and 17 patients with septic shock were included in the present study. In addition, 20 healthy subjects were recruited as the control group. Peripheral blood was collected from all subjects and a rat cardiomyocyte model of myocardial injury was constructed. Reverse transcription-quantitative polymerase chain reaction was used to measure miR-494-3p expression, while cell counting kit-8 assays were performed to assess cell proliferation. Flow cytometry was performed to investigate cell cycle distribution and apoptosis. Lactate dehydrogenase (LDH) assays were performed to measure LDH levels. ELISA was also performed to measure LDH, tumor necrosis factor (TNF)-α and interleukin (IL)-6 levels in cell culture supernatants. Western blotting was employed to detect phosphatase and tensin homolog (PTEN) protein expression and dual luciferase reporter assays were performed to identify the interaction between miR-494-3p and PTEN mRNA. Reduced miR-494-3p expression was correlated with myocardial damage in patients with septic shock. Sera from patients with septic shock downregulated miR-494-3p expression in rat cardiomyocytes. miR-494-3p overexpression inhibited rat cardiomyocyte injury induced by treatment with sera from patients with septic shock. Furthermore, miR-494-3p overexpression reduced the synthesis and release of TNF-α and IL-6 from rat cardiomyocytes. PTEN knockdown alleviated rat cardiomyocyte injury following treatment with serum from patients with septic shock. PTEN was demonstrated to induce the release of TNF-α and IL-6 from rat cardiomyocytes treated with septic shock serum, while miR-494-3p was demonstrated to bind to the 3′-untranslated seed region of PTEN mRNA to regulate its expression. The results of the present study suggest that miR-494-3p is downregulated in the peripheral blood of patients with septic shock and is negatively correlated with myocardial injury. The present study also indicates that miR-494-3p regulates PTEN expression, inhibits sepsis-induced myocardial injury and protects the function of cardiomyocytes. The protective effect and mechanism of action of miR-494-3p indicate that it has potential for use in the clinical diagnosis and therapy of myocardial damage.
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Affiliation(s)
- Peng Wu
- Intensive Medicine Department, Linyi Central Hospital, Linyi, Shandong 276400, P.R. China
| | - Lingchen Kong
- Intensive Medicine Department, Linyi Central Hospital, Linyi, Shandong 276400, P.R. China
| | - Jianzhong Li
- Intensive Medicine Department, Linyi Central Hospital, Linyi, Shandong 276400, P.R. China
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Novel Mechanistic Roles for Ankyrin-G in Cardiac Remodeling and Heart Failure. JACC Basic Transl Sci 2018; 3:675-689. [PMID: 30456339 PMCID: PMC6234521 DOI: 10.1016/j.jacbts.2018.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/05/2018] [Accepted: 07/31/2018] [Indexed: 12/25/2022]
Abstract
The pathogenesis of human heart failure is complex, and the creation of new therapeutic strategies for human heart failure is critical. Identifying the molecular pathways underlying heart failure is important to define potential new therapeutic targets. Ankyrin polypeptides serve to target and stabilize membrane proteins in cardiomyocytes. Ankyrin-G levels are altered in humans and mice with heart failure, and mice lacking ankyrin-G in cardiomyocytes develop cardiomyopathy and systolic dysfunction. Mechanistically, ankyrin-G is necessary for the expression and localization of critical myocyte proteins essential for regulating cardiac structural and electrical activity.
Ankyrin polypeptides are intracellular proteins responsible for targeting cardiac membrane proteins. Here, the authors demonstrate that ankyrin-G plays an unexpected role in normal compensatory physiological remodeling in response to myocardial stress and aging; the authors implicate disruption of ankyrin-G in human heart failure. Mechanistically, the authors illustrate that ankyrin-G serves as a key nodal protein required for cardiac myofilament integration with the intercalated disc. Their data define novel in vivo mechanistic roles for ankyrin-G, implicate ankyrin-G as necessary for compensatory cardiac physiological remodeling under stress, and implicate disruption of ankyrin-G in the development and progression of human heart failure.
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Key Words
- AnkG, ankyrin-G
- DSP, desmoplakin
- ECG, electrocardiogram
- HF, heart failure
- LV, left ventricular
- Nav1.5
- PBS, phosphate-buffered saline
- PKP2, plakophilin-2
- TAC, transverse aortic constriction
- TUNEL, terminal deoxynucleotidyl transferase dUTP nick-end labeling
- WT, wild-type
- ankyrin
- arrhythmia
- cKO, cardiomyocyte-specific knockout
- cytoskeleton
- heart failure
- ion channel
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O’Malley KJ, Bowling JL, Stinson E, Cole KS, Mann BJ, Namjoshi P, Hazlett KRO, Barry EM, Reed DS. Aerosol prime-boost vaccination provides strong protection in outbred rabbits against virulent type A Francisella tularensis. PLoS One 2018; 13:e0205928. [PMID: 30346998 PMCID: PMC6197691 DOI: 10.1371/journal.pone.0205928] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/03/2018] [Indexed: 12/15/2022] Open
Abstract
Tularemia, also known as rabbit fever, is a severe zoonotic disease in humans caused by the gram-negative bacterium Francisella tularensis (Ft). While there have been a number of attempts to develop a vaccine for Ft, few candidates have advanced beyond experiments in inbred mice. We report here that a prime-boost strategy with aerosol delivery of recombinant live attenuated candidate Ft S4ΔaroD offers significant protection (83% survival) in an outbred animal model, New Zealand White rabbits, against aerosol challenge with 248 cfu (11 LD50) of virulent type A Ft SCHU S4. Surviving rabbits given two doses of the attenuated strains by aerosol did not exhibit substantial post-challenge fevers, changes in erythrocyte sedimentation rate or in complete blood counts. At a higher challenge dose (3,186 cfu; 139 LD50), protection was still good with 66% of S4ΔaroD-vaccinated rabbits surviving while 50% of S4ΔguaBA vaccinated rabbits also survived challenge. Pre-challenge plasma IgG titers against Ft SCHU S4 corresponded with survival time after challenge. Western blot analysis found that plasma antibody shifted from predominantly targeting Ft O-antigen after the prime vaccination to other antigens after the boost. These results demonstrate the superior protection conferred by a live attenuated derivative of virulent F. tularensis, particularly when given in an aerosol prime-boost regimen.
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Affiliation(s)
- Katherine J. O’Malley
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Jennifer L. Bowling
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Elizabeth Stinson
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Kelly S. Cole
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Barbara J. Mann
- Department of Medicine, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, United States of America
| | - Prachi Namjoshi
- Department for Immunology & Microbial Diseases, Albany Medical College, Albany, NY, United States of America
| | - Karsten R. O. Hazlett
- Department for Immunology & Microbial Diseases, Albany Medical College, Albany, NY, United States of America
| | - Eileen M. Barry
- Center for Vaccine Development, University of Maryland Baltimore, Baltimore, MD, United States of America
| | - Douglas S. Reed
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA, United States of America
- * E-mail:
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20
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The role of mitochondria in sepsis-induced cardiomyopathy. Biochim Biophys Acta Mol Basis Dis 2018; 1865:759-773. [PMID: 30342158 DOI: 10.1016/j.bbadis.2018.10.011] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 02/08/2023]
Abstract
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Myocardial dysfunction, often termed sepsis-induced cardiomyopathy, is a frequent complication and is associated with worse outcomes. Numerous mechanisms contribute to sepsis-induced cardiomyopathy and a growing body of evidence suggests that bioenergetic and metabolic derangements play a central role in its development; however, there are significant discrepancies in the literature, perhaps reflecting variability in the experimental models employed or in the host response to sepsis. The condition is characterised by lack of significant cell death, normal tissue oxygen levels and, in survivors, reversibility of organ dysfunction. The functional changes observed in cardiac tissue may represent an adaptive response to prolonged stress that limits cell death, improving the potential for recovery. In this review, we describe our current understanding of the pathophysiology underlying myocardial dysfunction in sepsis, with a focus on disrupted mitochondrial processes.
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Chen J, Wang B, Lai J, Braunstein Z, He M, Ruan G, Yin Z, Wang J, Cianflone K, Ning Q, Chen C, Wang DW. Trimetazidine Attenuates Cardiac Dysfunction in Endotoxemia and Sepsis by Promoting Neutrophil Migration. Front Immunol 2018; 9:2015. [PMID: 30233596 PMCID: PMC6131494 DOI: 10.3389/fimmu.2018.02015] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/15/2018] [Indexed: 12/20/2022] Open
Abstract
Aims: Cardiac dysfunction can be a fatal complication during severe sepsis. The migration of neutrophils is significantly impaired during severe sepsis. We sought to determine the role of trimetazidine (TMZ) in regulation of neutrophil migration to the heart in a mouse model of sepsis and endotoxemia, and to identify the mechanism whereby TMZ confers a survival advantage. Methods and Results: C57/BL6 mice were (1) injected with LPS followed by 24-h TMZ administration, or (2) treated with TMZ (20 mg/kg/day) for 1 week post cecal ligation and puncture (CLP) operation. Echocardiography and Millar system detection showed that TMZ alleviated cardiac dysfunction and histological staining showed the failure of neutrophils migration to heart in both LPS- and CLP-induced mice. Bone marrow transplantation revealed that TMZ-pretreated bone marrow cells improved LPS- and CLP-induced myocardial dysfunction and enhanced neutrophil recruitment in heart. In CXCL2-mediated chemotaxis assays, TMZ increased neutrophils migration via AMPK/Nrf2-dependent up-regulation of CXCR2 and inhibition of GRK2. Furthermore, using luciferase reporter gene and chromatin immunoprecipitation assays, we found that TMZ promoted the binding of the Nrf2 and CXCR2 promoter regions directly. Application of CXCR2 inhibitor completely reversed the protective effects of TMZ in vivo. Co-culture of neutrophils and cardiomyocytes further validated that TMZ decreased LPS-induced cardiomyocyte pyroptosis by targeting neutrophils. Conclusion: Our findings suggested TMZ as a potential therapeutic agent for septic or endotoxemia associated cardiac dysfunction in mice. STUDY HIGHLIGHTS What is the current knowledge on the topic? Migration of neutrophils is significantly impaired during severe sepsis, but the underlying mechanisms remain unknown. What question did this study address? The effects of TMZ on cardiac dysfunction via neutrophils migration. What this study adds to our knowledge TMZ attenuated LPS-induced cardiomyocyte pyroptosis and cardiac dysfunction by promoting neutrophils recruitment to the heart tissues via CXCR2. How this might change clinical pharmacology or translational science Our findings suggested TMZ as a potential therapeutic agent for septic cardiac dysfunction.
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Affiliation(s)
- Jing Chen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Bei Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China.,Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinsheng Lai
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Zachary Braunstein
- Department of Internal Medicine, The Ohio State University, Columbus, OH, United States
| | - Mengying He
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Guoran Ruan
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Zhongwei Yin
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Jin Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Katherine Cianflone
- Centre de Recherche de l'Institut Universitaire de Cardiologie & Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Qin Ning
- Department of Infectious Disease, Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Chen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
| | - Dao Wen Wang
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Wuhan, China
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22
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The influence of esmolol on septic shock and sepsis: A meta-analysis of randomized controlled studies. Am J Emerg Med 2018; 36:470-474. [DOI: 10.1016/j.ajem.2017.11.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 10/26/2017] [Accepted: 11/06/2017] [Indexed: 01/07/2023] Open
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Wu D, Shi L, Li P, Ni X, Zhang J, Zhu Q, Qi Y, Wang B. Intermedin 1-53 Protects Cardiac Fibroblasts by Inhibiting NLRP3 Inflammasome Activation During Sepsis. Inflammation 2018; 41:505-514. [PMID: 29192367 DOI: 10.1007/s10753-017-0706-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Sepsis is a disease that occurs as a result of systemic inflammatory response syndrome (SIRS) in response to an infection, contributing to multiple organ dysfunction and a high mortality rate. Interleukin-lβ (IL-1β) is a cytokine that plays critical roles in inflammation and cardiac dysfunction during severe sepsis. Intermedin1-53 (IMD1-53) has been recently discovered to possess potential endogenous anti-inflammatory and strong cardiovascular protective effects. To investigate whether IMD1-53 can inhibit the NLRP3/caspase-1/IL-1β pathway to alleviate cardiac injury and rescue heart function, sepsis was induced in vivo by caecal ligation and puncture (CLP) surgery, and lipopolysaccharides were used as septic stressors for cardiac fibroblasts (CFs) in vitro. The expressions of IMD1-53 receptors in sepsis rat heart were increased. After IMD1-53 treatment, inflammation caused by sepsis in vivo was greatly reduced, as shown by the downregulation of apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), nucleotide-binding domain and leucine-rich repeat containing family, pyrin containing 3 (NLRP3), pro-IL-1β, caspase 1, and nuclear translocation of nuclear factor-κB (NF-kB) protein levels. In addition, cardiac function was significantly improved and mean arterial blood pressure (MABP) increased by 34.8% (P < 0.05) which almost back to normal. Surprisingly, IMD1-53 inhibited cell apoptosis, as caspase 3 activity and Bax expression was significantly reduced in the heart upon IMD1-53 treatment. IMD1-53 abolished the upregulation of ASC, NLRP3, and caspase 1 protein levels in CFs induced by lipopolysaccharide (LPS). IMD1-53 increased cell survival rates and inhibited IL-1β production in the cell culture medium. IMD1-53 can protect against inflammation and heart injury during sepsis via attenuating the NLRP3/caspase-1/IL-1β pathway.
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Affiliation(s)
- Di Wu
- The Peking University Aerospace School of Clinical Medicine, Peking University Health Science Center, Beijing, 100191, China
| | - Lin Shi
- The Peking University People's Hospital, Beijing, 100191, China
| | - Pengyang Li
- Texas Heart Institute, Houston, TX, 77030, USA
| | - Xianqiang Ni
- Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Peking University Health Science Center, Beijing, 100191, China
| | - Jinsheng Zhang
- Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Peking University Health Science Center, Beijing, 100191, China
| | - Qing Zhu
- Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Peking University Health Science Center, Beijing, 100191, China
| | - Yongfen Qi
- Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Peking University Health Science Center, Beijing, 100191, China.
| | - Bin Wang
- The Peking University Aerospace School of Clinical Medicine, Peking University Health Science Center, Beijing, 100191, China.
- The First Affiliated Hospital of Shantou University Medical College, Guangdong, 515041, China.
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Restrepo MI, Reyes LF. Pneumonia as a cardiovascular disease. Respirology 2018; 23:250-259. [PMID: 29325222 DOI: 10.1111/resp.13233] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/05/2017] [Indexed: 01/08/2023]
Abstract
Community-acquired pneumonia (CAP) is an important cause of death around the globe. Up to 30% of patients admitted to hospital for CAP develop cardiovascular complications (i.e. new/worsening heart failure, new/worsening arrhythmias, myocardial infarctions and/or strokes), acutely and up to 10 years thereafter. Cardiac complications result from complex interactions between preexisting conditions, relative ischaemia, upregulation of the sympathetic system, systemic inflammation and direct pathogen-mediated damage to the cardiovascular system. The exact mechanisms underlying the direct host-pathogen interactions are of great interest to identify potential therapeutic and preventative targets for CAP. In this review, we summarize the epidemiological data, risk factors and the pathogen-driven cardiovascular damage affecting patients with CAP.
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Affiliation(s)
- Marcos I Restrepo
- Division of Pulmonary Diseases and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Luis F Reyes
- Division of Pulmonary Diseases and Critical Care Medicine, South Texas Veterans Health Care System, San Antonio, TX, USA.,Department of Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
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Narváez I, Canabal A, Martín C, Sánchez M, Moron A, Alcalá J, Giacoman S, Magro M. Incidence and evolution of sepsis-induced cardiomyopathy in a cohort of patients with sepsis and septic shock. Med Intensiva 2017; 42:283-291. [PMID: 29100618 DOI: 10.1016/j.medin.2017.08.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/11/2017] [Accepted: 08/26/2017] [Indexed: 12/13/2022]
Abstract
OBJETIVE The aim of this study was to establish the incidence of septic cardiomyopathy (SM) in patients with sepsis and septic shock, to describe its characteristics and testing its evolution. DESIGN Prospective cohort study. PARTICIPANTS We included 57 consecutive patients admitted to Intensive Care Unit, who met criteria of sepsis and septic shock. PRINCIPAL VARIABLES OF INTEREST Clinical and biochemical variables were analyzed. An echocardiogram was performed in the first 24hours of admission, determining myocardial function parameters, and if the patients had left ventricular ejection fraction (LVEF)<50%) a second echocardiogram was performed. AMBIT Intensive medical and surgical Care Service for Adults in University Hospital. RESULTS The mean age of the patients was 62,1±16,3 years. 58% were males. 22.8% had left ventricular dysfunction. The mean LVEF in patients with MS was lower than those without SM (34.1±10.6 vs 60.7±6.94%, P<.001), with complete recovery, in survivors, after the acute event (LVEF at discharge 56.1±6.3%, P=.04). Patients with SM had higher levels of procalcitonin (47.1±35.4 vs 18.9±24.5; P=.02) and higher score on the Sequential Organ Failure Assessment (SOFA score) (9.91±3.82 vs 7.47±3.41; P=.037). Mortality was not significantly different between both groups [4 (30.8%) vs 4 (9.1%); P=.07]. CONCLUSIONS SM is not uncommon and is related to a higher scores on the severity scales. In the survivors, LVEF normalized after the recovery of the acute event.
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Affiliation(s)
- I Narváez
- Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, España.
| | - A Canabal
- Servicio de Medicina Intensiva, Hospital Virgen de la Salud, Toledo, España
| | - C Martín
- Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, España
| | - M Sánchez
- Servicio de Medicina Intensiva, Hospital Virgen de la Salud, Toledo, España
| | - A Moron
- Universidad de Castilla La Mancha, Ciudad Real, España
| | - J Alcalá
- Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, España
| | - S Giacoman
- Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, España
| | - M Magro
- Servicio de Medicina Intensiva, Hospital Virgen de la Salud, Toledo, España
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