Myocardial strain/stress changes identified by echocardiography may reveal early sepsis-induced myocardial dysfunction

Wang, Xiaoting; Su, Longxiang; Yang, Ru; Zhang, Hongmin

doi:10.1177/0300060517737434

Cited by 11 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is achieved by necrotizing the end of the cecum following surgery and enabling the contents to enter the abdominal cavity following intestinal puncture; however, this method is affected by the bacterial composition of the intestinal contents and differences between operators ( 44 ). The model of sepsis induced with LPS by tail vein injection is acute, and acute cardiac dysfunction can be induced within 4–6 h ( 45 ). LPS can also be injected intraperitoneally to induce septic myocardial injury after 6 h; the dosage of LPS is easy to control and the surgery is simple; however, the model of LPS administration does not reflect all the complex physiological human responses, such as proinflammatory cytokines production, hemodynamic response ( 46 , 47 ).…”

Section: Discussionmentioning

confidence: 99%

Astaxanthin suppresses lipopolysaccharide‑induced myocardial injury by regulating MAPK and PI3K/AKT/mTOR/GSK3β signaling

et al. 2020

View full text Add to dashboard Cite

Cardiac dysfunction is a significant manifestation of sepsis and it is associated with the prognosis of the disease. Astaxanthin (ATX) has been discovered to serve a variety of pharmacological effects, including anti-inflammatory, antioxidant and antiapoptotic properties. The present study aimed to investigate the role and mechanisms of ATX in sepsis-induced myocardial injury. Male C57BL/6 mice were divided into three groups (15 mice per group): Control group, lipopolysaccharide (LPS) group and LPS + ATX group. The cardiac dysfunction model was induced through an intraperitoneal injection of LPS (10 mg/kg) and ATX (40 mg/kg) was administered to the LPS + ATX group by intraperitoneal injection 30 min following the administration of LPS. All animals were sacrificed after 24 h. Inflammatory cytokine levels in the serum were detected using ELISAs, and cardiac B-type natriuretic peptide (BNP) levels were analyzed using western blot analysis and reverse transcription-quantitative PCR. Furthermore, the extent of myocardial injury was evaluated using pathological analysis, and cardiomyocyte apoptosis was analyzed using a TUNEL assay, in addition to determining the expression levels of Bcl-2 and Bax. The expression levels of proteins involved in the mitogen activated protein kinase (MAPK) and PI3K/AKT signaling pathways were also analyzed using western blot analysis. ATX significantly suppressed the LPS-induced increased production of TNF-α and IL-6 and suppressed the protein expression levels of BNP, Bax and Bcl-2 to normal levels. ATX also prevented the histopathological changes to the myocardial tissue and reduced the extent of necrosis. Furthermore, the treatment with ATX suppressed the LPS-activated MAPK and PI3K/AKT signaling. ATX additionally exerted a protective effect on cardiac dysfunction caused by sepsis by inhibiting MAPK and PI3K/AKT signaling.

show abstract

Section: Discussionmentioning

confidence: 99%

Astaxanthin suppresses lipopolysaccharide‑induced myocardial injury by regulating MAPK and PI3K/AKT/mTOR/GSK3β signaling

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In addition, the technique is free of radiation, in contrast with other functional tests, as well as simple in its application, with a small ultrasound probe placed on the chest without a need for large cameras [ 8 ] or claustrophobic tubes [ 9 ]. While the conventional DSE assessment of ischemia is based on the development of wall motion abnormalities at fast heart rate with respect to resting [ 10 ], other echocardiographic modalities have been used and proved to be better in objectively assessing myocardial ischemic dysfunction, including myocardial velocities [ 11 ], myocardial deformation in the form of strain and strain rate abnormalities and myocardial perfusion disturbances [ 12 , 13 ]. The aim of this study was to evaluate the accuracy of cardiac Doppler parameters in predicting the presence and significance of CAD.…”

Section: Introductionmentioning

confidence: 99%

Left Ventricular Myocardial and Cavity Velocity Disturbances Are Powerful Predictors of Significant Coronary Artery Stenosis

Bytyçi

Alves

et al. 2022

JCM

View full text Add to dashboard Cite

Background and Aim: Dobutamine stress echocardiography (DSE) is a well-established noninvasive investigation for significant coronary artery disease (CAD). The aim of this study was to evaluate the accuracy of cardiac Doppler parameters in predicting CAD. Methods: We prospectively studied 103 consecutive patients with suspected CAD based on typical symptoms; 59 proved to have CAD, and 44 patients proved to have no-CAD (n = 44). All patients underwent a complete stress Doppler echocardiographic examination. Total isovolumic time (T-IVT) as a marker of cavity dyssynchrony and wall motion score index (WMSI) were also calculated. Results: At peak dobutamine stress, the compromised LV longitudinal excursion (MAPSE), systolic septal and lateral velocities (s’), and diastolic indices were more pronounced in the CAD patients compared with those without CAD, but LV dimension did not differ between groups (p > 0.05). The WMSI was higher and t-IVT more prolonged in patients with CAD (p < 0.01 for both). Similarly, the changes were more pronounced in patients with significant CAD compared with insignificant CAD. On multivariate model, Δ mean s’, OR 2.016 (1.610 to 3.190; p < 0.001), Δ E velocity OR 2.502 (1.179 to 1.108; p < 0.001), Δ t-IVT 2.206 (1.180 to 2.780; p < 0.001) and Δ WMSI OR 1.911 (1.401 to 3.001; p = 0.001) were the most powerful independent predictors of the presence of CAD, particularly when significant (>75%). Δ mean s’ < 5.0 was 85% sensitive, 89% specific with AUC 0.92. Respective values for Δ E velocity <6.0 cm/s were 82%, 90% and 0.91; for Δ t-IVT > 4.5, 78%, 77% and 0.81 and for Δ FT ≥ 150 ms, 76%, 78% and 0.84 in predicating significant CAD. WMSI ≥ 0.7 was 75% sensitive, 77% specific with AUC of 0.81 in predicting significant CAD. The accuracy of DSE was higher in significant CAD compared to insignificant CAD (80% vs. 74%; p = 0.03). Conclusions: Compromised LV longitudinal systolic function, lower delta E wave, prolonged t-IVT, and increased WMSI were the most powerful independent predictors of the presence and significance of CAD. These finding strengthen the role of comprehensive DSE analysis in diagnosing ischemic disturbances secondary to significant CAD.

show abstract

“…In patients who subsequently die, the RVEF and right ventricular end-diastolic volume may not change. 8 …”

Section: The Characteristics Of Septic Myocardial Depressionmentioning

confidence: 99%

Progress in the Clinical Assessment and Treatment of Myocardial Depression in Critically Ill Patient with Sepsis

Shen¹,

Zhang²,

Zhang³

et al. 2022

JIR

View full text Add to dashboard Cite

Myocardial inhibition is the main cause of death in patients with sepsis.In recent years, methodological differences in the diagnosis, assessment, and treatment of septic myocardial depression have been observed, and how to objectively and accurately evaluate the degree of myocardial depression and the timing of treatment strategies have generally been the focus of this area of research. Based on the relevant research at home and abroad, the current review summarizes the clinical characteristics, methodological diagnosis, and symptomatic treatment of septic myocardial depression. The aim of doing so is to provide a reference for the early identification and treatment of patients with sepsis and myocardial depression.

show abstract

Myocardial strain/stress changes identified by echocardiography may reveal early sepsis-induced myocardial dysfunction

Cited by 11 publications

References 33 publications

Astaxanthin suppresses lipopolysaccharide‑induced myocardial injury by regulating MAPK and PI3K/AKT/mTOR/GSK3β signaling

Astaxanthin suppresses lipopolysaccharide‑induced myocardial injury by regulating MAPK and PI3K/AKT/mTOR/GSK3β signaling

Left Ventricular Myocardial and Cavity Velocity Disturbances Are Powerful Predictors of Significant Coronary Artery Stenosis

Progress in the Clinical Assessment and Treatment of Myocardial Depression in Critically Ill Patient with Sepsis

Contact Info

Product

Resources

About