Dysfonctionnement myocardique et choc septique

Gibot, Sébastien; Lévy, Bruno; Nevière, Rémi; Cariou, Alain; Lesur, Olivier

doi:10.1051/medsci/200420121115

Cited by 11 publications

(1 citation statement)

References 20 publications

(25 reference statements)

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“…Several pathophysiological mechanisms other than thrombus-associated myocardial damage could play a major role, including reversible myocardial membrane leakage and/or cytokine mediated apoptosis in these patients. It has been suggested that sepsis-induced myocardial dysfunction involves pro-inflammatory cytokines including tumour necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6, 19 nitrite oxide, alteration of beta-adrenergic receptors, 20 apoptosis and calcium abnormalities particularly a decreased myocardial fibers sensibility. 5…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of High-sensitivity Troponin I in Patients with Septic Shock: A Prospective Observational Study

Jendoubi

Jerbi

Maamar

et al. 2019

Indian Journal of Critical Care Medicine

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Background Myocardial dysfunction is one of the mechanisms involved in the pathophysiology of septic shock. The role of troponin as a surrogate of myocardial injury in septic shock is still debated. The aim of this study was to assess the prognostic value of high-sensitivity cardiac troponin I (hs-cTnI) assay in predicting 28-day mortality in patients with septic shock. Materials and Methods Prospective study including 75 patients with septic shock admitted to a medico-surgical ICU from January to December 2017. Patients under the age of 18 years, known pregnancy and patients in post–cardiac arrest were excluded. Clinical and demographic data including age, gender, comorbidities, SAPS II and SOFA scores were collected. Hs-cTnI was measured soon after admission and 12, 24, 48 and 72 after. Receiver operating characteristic (ROC) analysis was performed to identify the most useful troponin I cut-off level for the prediction of 28-day mortality. A p <0.05 was considered significant. Results Seventy-five (M/F = 53/22) patients with septic shock were included in the study. The median SOFA and SAPS II scores were 10 and 42, respectively. The median duration of mechanical ventilation was 8 days and the median length of ICU stay was 11 days. The 28-day mortality was 54.6%. We found a high prevalence (47%) of elevated hs-cTnI in patients with septic shock. Median hs-cTnI on admission in the whole group was 36 ng/L. The 28-day mortality was found to be related to age ( p <0.001), SAPS II score ( p = 0.001), mean arterial pressure ( p = 0.038), lactate ( p <0.001) and glomerular filtration rate ( p <0.001). Hs-cTnI levels were significantly higher in non-survival group than survival one at all time points: H12 ( p = 0.006), H24 ( p = 0.003), H48 ( p = 0.005) and H72 (p=0.001). In multivariate analysis, hs-cTnI at H72 was independently associated with 28-day mortality. Conclusion Hs-cTnI elevation at 72 hours was associated with 28-day mortality in septic shock patients. How to cite this article Jendoubi A, Jerbi S, Maamar E, Abbess A, Samoud Z, Kanzari L, et al . Prognostic Value of High-Sensitivity Troponin I in Patients with Septic Shock: A Prospective Observational Study. Indian J Crit Care Med 2019;23(7):320–325.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of High-sensitivity Troponin I in Patients with Septic Shock: A Prospective Observational Study

Jendoubi

Jerbi

Maamar

et al. 2019

Indian Journal of Critical Care Medicine

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Ginsenoside Rg1 attenuates cardiomyocyte apoptosis and inflammation via the TLR4/NF‐kB/NLRP3 pathway

Luo

Yan

Sun

et al. 2019

J of Cellular Biochemistry

140

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Sepsis‐induced myocardial dysfunction (SIMD) causes high mortality in seriously ill patients. Ginsenoside Rg1 has been proven to have effective anti‐inflammatory and antiapoptotic properties. However, the specific role of Rg1 in SIMD and the molecular mechanism remain unclear. Hence, we aimed to investigate the latent effects of ginsenoside Rg1 against SIMD and explore its underlying mechanisms. Male C57BL/6J mice and neonatal rat cardiomyocytes (NRCMs) were used as in vivo and in vitro models, respectively. Western blot analysis was used to detect the level of protein expression, and reverse transcription polymerase chain reaction was conducted to determine the messenger RNA expression of inflammatory factors. The terminal deoxynucleotidyl transferase‐mediated nick end labeling assay and flow cytometry were used to determine the apoptosis rate. Echocardiography was performed to assess cardiac function. The results showed that Rg1 improved cardiac function and attenuated lipopolysaccharide (LPS)‐induced apoptosis and inflammation in mice. In addition, in NRCMs, Rg1 downregulated the expression of LPS‐induced inflammatory cytokines and reversed the increased expression of Toll‐like receptor 4 (TLR4), nuclear factor‐κB (NF‐κB), and NOD‐like receptor 3 (NLRP3). In addition, treatment with TLR4 small interfering RNA (siRNA), a p‐NF‐κB inhibitor, or NLRP3 siRNA suppressed LPS‐induced apoptosis and inflammation. In conclusion, Rg1 can attenuate LPS‐induced inflammation and apoptosis both in NRCMs and septic mice and restore impaired cardiac function. Moreover, Rg1 may exert its effect via blocking the TLR4/NF‐κB/NLRP3 pathway.

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Myocardial lactate deprivation is associated with decreased cardiovascular performance, decreased myocardial energetics, and early death in endotoxic shock

et al. 2007

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Dysfonctionnement myocardique et choc septique

Cited by 11 publications

References 20 publications

Prognostic Value of High-sensitivity Troponin I in Patients with Septic Shock: A Prospective Observational Study

Prognostic Value of High-sensitivity Troponin I in Patients with Septic Shock: A Prospective Observational Study

Ginsenoside Rg1 attenuates cardiomyocyte apoptosis and inflammation via the TLR4/NF‐kB/NLRP3 pathway

Myocardial lactate deprivation is associated with decreased cardiovascular performance, decreased myocardial energetics, and early death in endotoxic shock

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