Inflamación y disfunción cardiaca durante la sepsis, distrofia muscular y miocarditis
Inflammation and cardiac dysfunction during sepsis, muscular dystrophy, and myocarditis.
Li Y, Ge S, Peng Y, Chen X.
Burn Trauma [serial online] 2013 [cited 2013 Dec 27];1:109-21.
Abstract
Inflammation plays an important role in cardiac dysfunction under different situations. Acute systemic inflammation occurring in patients with severe burns, trauma, and inflammatory diseases causes cardiac dysfunction, which is one of the leading causes of mortality in these patients. Acute sepsis decreases cardiac contractility and impairs myocardial compliance. Chronic inflammation such as that occurring in Duchenne muscular dystropshy and myocarditis may cause adverse cardiac remodeling including myocyte hypertrophy and death, fibrosis, and altered myocyte function. However, the underlying cellular and molecular mechanisms for inflammatory cardiomyopathy are still controversial probably due to multiple factors involved. Potential mechanisms include the change in circulating blood volume; a direct inhibition of myocyte contractility by cytokines (tumor necrosis factor (TNF)-a, interleukin (IL)-1b); abnormal nitric oxide and reactive oxygen species (ROS) signaling; mitochondrial dysfunction; abnormal excitation-contraction coupling; and reduced calcium sensitivity at the myofibrillar level and blunted b-adrenergic signaling. This review will summarize recent advances in diagnostic technology, mechanisms, and potential therapeutic strategies for inflammation-induced cardiac dysfunction.
Keywords: Burn, inflammation, sepsis, Duchenne muscular dystrophy, cardiac dysfunction, contractility
http://www.burnstrauma.com/text.asp?2013/1/3/109/123072
Monitoreo e identificación de la sepsis a través de una medida compuesta de la variabilidad del ritmo cardíaco
Monitoring and identification of sepsis development through a composite measure of heart rate variability.
Bravi A, Green G, Longtin A, Seely AJ.
PLoS One. 2012;7(9):e45666. doi: 10.1371/journal.pone.0045666. Epub 2012 Sep 19.
Abstract
Tracking the physiological conditions of a patient developing infection is of utmost importance to provide optimal care at an early stage. This work presents a procedure to integrate multiple measures of heart rate variability into a unique measure for the tracking of sepsis development. An early warning system is used to illustrate its potential clinical value. The study involved 17 adults (age median 51 (interquartile range 46-62)) who experienced a period of neutropenia following chemoradiotherapy and bone marrow transplant; 14 developed sepsis, and 3 did not. A comprehensive panel (N = 92) of variability measures was calculated for 5 min-windows throughout the period of monitoring (12 ± 4 days). Variability measures underwent filtering and two steps of data reduction with the objective of enhancing the information related to the greatest degree of change. The proposed composite measure was capable of tracking the development of sepsis in 12 out of 14 patients. Simulating a real-time monitoring setting, the sum of the energy over the very low frequency range of the composite measure was used to classify the probability of developing sepsis. The composite revealed information about the onset of sepsis about 60 hours (median value) before of sepsis diagnosis. In a real monitoring setting this quicker detection time would be associated to increased efficacy in the treatment of sepsis, therefore highlighting the potential clinical utility of a composite measure of variability.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446945/pdf/pone.0045666.pdf
Cardiomiopatía inducida por sepsis
Sepsis-induced cardiomyopathy.
Romero-Bermejo FJ, Ruiz-Bailen M, Gil-Cebrian J, Huertos-Ranchal MJ.
Curr Cardiol Rev. 2011 Aug;7(3):163-83.
Abstract
Myocardial dysfunction is one of the main predictors of poor outcome in septic patients, with mortality rates next to 70%. During the sepsis-induced myocardial dysfunction, both ventricles can dilate and diminish its ejection fraction, having less response to fluid resuscitation and catecholamines, but typically is assumed to be reversible within 7-10 days. In the last 30 years, It's being subject of substantial research; however no explanation of its etiopathogenesis or effective treatment have been proved yet. The aim of this manuscript is to review on the most relevant aspects of the sepsis-induced myocardial dysfunction, discuss its clinical presentation, pathophysiology, etiopathogenesis, diagnostic tools and therapeutic strategies proposed in recent years.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263481/pdf/CCR-7-163.pdf
Sepsis y riesgo de enfermedad cardiovascular
Dr. Pedro Villarroel González-Eliper. Pedro Villarroel González-Elipe
Médico especialista en Medicina Interna. Coordinador del Servicio de Urgencias del Hospital Clínico San Carlos, Madrid.
Profesor asociado de Medicina de la Universidad Complutense de Madrid
Introducción a la sepsis y el riesgo cardiovascular
Diferentes microbios pueden invadir el torrente circulatorio y afectar a distintos órganos, entre otros el corazón, a través de una serie de eventos tóxicos, debidos a la liberación de productos del microorganismo y del propio huésped, que interaccionan y pueden dañar la funcionalidad
del músculo cardíaco, lo que sucede en el caso de algunas situaciones tratadas en este capítulo, y que son conocidas como sepsis.
http://www.fbbva.es/TLFU/microsites/salud_cardio/fbbva_libroCorazon_Cap_20.html?gOrri=1
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Inflammation and cardiac dysfunction during sepsis, muscular dystrophy, and myocarditis.
Li Y, Ge S, Peng Y, Chen X.
Burn Trauma [serial online] 2013 [cited 2013 Dec 27];1:109-21.
Abstract
Inflammation plays an important role in cardiac dysfunction under different situations. Acute systemic inflammation occurring in patients with severe burns, trauma, and inflammatory diseases causes cardiac dysfunction, which is one of the leading causes of mortality in these patients. Acute sepsis decreases cardiac contractility and impairs myocardial compliance. Chronic inflammation such as that occurring in Duchenne muscular dystropshy and myocarditis may cause adverse cardiac remodeling including myocyte hypertrophy and death, fibrosis, and altered myocyte function. However, the underlying cellular and molecular mechanisms for inflammatory cardiomyopathy are still controversial probably due to multiple factors involved. Potential mechanisms include the change in circulating blood volume; a direct inhibition of myocyte contractility by cytokines (tumor necrosis factor (TNF)-a, interleukin (IL)-1b); abnormal nitric oxide and reactive oxygen species (ROS) signaling; mitochondrial dysfunction; abnormal excitation-contraction coupling; and reduced calcium sensitivity at the myofibrillar level and blunted b-adrenergic signaling. This review will summarize recent advances in diagnostic technology, mechanisms, and potential therapeutic strategies for inflammation-induced cardiac dysfunction.
Keywords: Burn, inflammation, sepsis, Duchenne muscular dystrophy, cardiac dysfunction, contractility
http://www.burnstrauma.com/text.asp?2013/1/3/109/123072
Monitoreo e identificación de la sepsis a través de una medida compuesta de la variabilidad del ritmo cardíaco
Monitoring and identification of sepsis development through a composite measure of heart rate variability.
Bravi A, Green G, Longtin A, Seely AJ.
PLoS One. 2012;7(9):e45666. doi: 10.1371/journal.pone.0045666. Epub 2012 Sep 19.
Abstract
Tracking the physiological conditions of a patient developing infection is of utmost importance to provide optimal care at an early stage. This work presents a procedure to integrate multiple measures of heart rate variability into a unique measure for the tracking of sepsis development. An early warning system is used to illustrate its potential clinical value. The study involved 17 adults (age median 51 (interquartile range 46-62)) who experienced a period of neutropenia following chemoradiotherapy and bone marrow transplant; 14 developed sepsis, and 3 did not. A comprehensive panel (N = 92) of variability measures was calculated for 5 min-windows throughout the period of monitoring (12 ± 4 days). Variability measures underwent filtering and two steps of data reduction with the objective of enhancing the information related to the greatest degree of change. The proposed composite measure was capable of tracking the development of sepsis in 12 out of 14 patients. Simulating a real-time monitoring setting, the sum of the energy over the very low frequency range of the composite measure was used to classify the probability of developing sepsis. The composite revealed information about the onset of sepsis about 60 hours (median value) before of sepsis diagnosis. In a real monitoring setting this quicker detection time would be associated to increased efficacy in the treatment of sepsis, therefore highlighting the potential clinical utility of a composite measure of variability.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446945/pdf/pone.0045666.pdf
Cardiomiopatía inducida por sepsis
Sepsis-induced cardiomyopathy.
Romero-Bermejo FJ, Ruiz-Bailen M, Gil-Cebrian J, Huertos-Ranchal MJ.
Curr Cardiol Rev. 2011 Aug;7(3):163-83.
Abstract
Myocardial dysfunction is one of the main predictors of poor outcome in septic patients, with mortality rates next to 70%. During the sepsis-induced myocardial dysfunction, both ventricles can dilate and diminish its ejection fraction, having less response to fluid resuscitation and catecholamines, but typically is assumed to be reversible within 7-10 days. In the last 30 years, It's being subject of substantial research; however no explanation of its etiopathogenesis or effective treatment have been proved yet. The aim of this manuscript is to review on the most relevant aspects of the sepsis-induced myocardial dysfunction, discuss its clinical presentation, pathophysiology, etiopathogenesis, diagnostic tools and therapeutic strategies proposed in recent years.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263481/pdf/CCR-7-163.pdf
Sepsis y riesgo de enfermedad cardiovascular
Dr. Pedro Villarroel González-Eliper. Pedro Villarroel González-Elipe
Médico especialista en Medicina Interna. Coordinador del Servicio de Urgencias del Hospital Clínico San Carlos, Madrid.
Profesor asociado de Medicina de la Universidad Complutense de Madrid
Introducción a la sepsis y el riesgo cardiovascular
Diferentes microbios pueden invadir el torrente circulatorio y afectar a distintos órganos, entre otros el corazón, a través de una serie de eventos tóxicos, debidos a la liberación de productos del microorganismo y del propio huésped, que interaccionan y pueden dañar la funcionalidad
del músculo cardíaco, lo que sucede en el caso de algunas situaciones tratadas en este capítulo, y que son conocidas como sepsis.
http://www.fbbva.es/TLFU/microsites/salud_cardio/fbbva_libroCorazon_Cap_20.html?gOrri=1
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
