期刊论文详细信息
Sepsis and the heart
Review
关键词: NITRIC-OXIDE SYNTHASE;    TUMOR-NECROSIS-FACTOR;    HMG-COA REDUCTASE;    MYOCARDIAL DEPRESSANT SUBSTANCE;    RIGHT-VENTRICULAR DYSFUNCTION;    ESCHERICHIA-COLI ENDOTOXIN;    GOAL-DIRECTED THERAPY;    SEPTIC SHOCK PATIENTS;    CARDIAC TROPONIN;    CONTRACTILE DYSFUNCTION;   
DOI  :  10.1161/CIRCULATIONAHA.106.678359
来源: SCIE
【 摘 要 】

Sepsis is generally viewed as a disease aggravated by an inappropriate immune response encountered in the afflicted individual. As an important organ system frequently compromised by sepsis and always affected by septic shock, the cardiovascular system and its dysfunction during sepsis have been studied in clinical and basic research for more than 5 decades. Although a number of mediators and pathways have been shown to be associated with myocardial depression in sepsis, the precise cause remains unclear to date. There is currently no evidence supporting global ischemia as an underlying cause of myocardial dysfunction in sepsis; however, in septic patients with coexistent and possibly undiagnosed coronary artery disease, regional myocardial ischemia or infarction secondary to coronary artery disease may certainly occur. A circulating myocardial depressant factor in septic shock has long been proposed, and potential candidates for a myocardial depressant factor include cytokines, prostanoids, and nitric oxide, among others. Endothelial activation and induction of the coagulatory system also contribute to the pathophysiology in sepsis. Prompt and adequate antibiotic therapy accompanied by surgical removal of the infectious focus, if indicated and feasible, is the mainstay and also the only strictly causal line of therapy. In the presence of severe sepsis and septic shock, supportive treatment in addition to causal therapy is mandatory. The purpose of this review is to delineate some characteristics of septic myocardial dysfunction, to assess the most commonly cited and reported underlying mechanisms of cardiac dysfunction in sepsis, and to briefly outline current therapeutic strategies and possible future approaches.

【 授权许可】

Free   

  文献评价指标  
  下载次数:0次 浏览次数:2次