Acute Reversible Myocardial Depression Associated with Sepsis.

Abstract

A 30-year-old man was admitted to our hospital for left lobar pneumonia with septic shock. Acute left-sided heart failure became evident as sepsis developed. Echocardiography revealed diffuse severe hypokinesis of the left ventricle (LV) and a pulmonary artery catheter showed Forrester subset II hemodynamics. Along with amelioration of sepsis and decrease of the serumconcentrations of tumor necrosis factor-a and interleukin-6, LV hypokinesis improved. It is suggested that the patient's heart failure mayhave been due to functional depression of myocardial contractility resulting from a direct effect of the cytokines towards the cardiomyocytes, the socalled "septic myocardial depression". (Internal Medicine 42: 60-65, 2003)

Temporal changes in tissue cardiorespiratory function during faecal peritonitis

“…This is consistent with other studies documenting myocardial depression in sepsis in both animal models [23] and humans [24,25]. By 24 h, when sepsis had become established, haemodynamic function had improved, despite persisting hyperlactataemia and a marked increase in clinical severity.…”

Recovery and recurrence of left ventricular systolic dysfunction in patients with idiopathic dilated cardiomyopathy

“…Congestive heart failure caused by systemic metabolic factors, such as sepsis, hypocalcemia, hypothyroidism, pheochromocytoma and peripartum cardiomyopathy, is another example. Improvement of LV systolic function may also be observed after treatment with interferon and amphotericin B (12)(13)(14)(15)(16)(17).…”

Cardiovascular Aspects of Septic Shock

“…For example, a patient with septic shock with hypotension, a low cardiac output, and low PAOP requires volume resuscitation. 146 Myocardial depression should be suspected if despite adequate volume resuscitation, the patient remains refractory (cardiac index <2.5 with a MAP <60 mm Hg). 3 For patients concerns about norepinephrine's potent vasoconstrictive effects made it the last drug of choice in the treatment of shock.…”