دورية أكاديمية
Cardiac Magnetic Resonance Studies in a Large Animal Model That Simulates the Cardiac Abnormalities of Human Septic Shock.
| العنوان: | Cardiac Magnetic Resonance Studies in a Large Animal Model That Simulates the Cardiac Abnormalities of Human Septic Shock. |
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| المؤلفون: | Ford VJ; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA., Applefeld WN; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA.; Division of Cardiology Duke University Medical Center Durham NC USA., Wang J; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA.; Emory University Atlanta GA USA., Sun J; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA., Solomon SB; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA., Sidenko S; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA., Feng J; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA., Sheffield C; The National Institutes of Health Library Bethesda MD USA., Klein HG; Department of Transfusion Medicine, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA., Yu ZX; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA., Torabi-Parizi P; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA., Danner RL; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA.; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA., Sachdev V; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA., Solomon MA; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA.; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA., Chen MY; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA., Natanson C; Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA.; National Heart Lung and Blood Institute National Institutes of Health Bethesda MD USA. |
| المصدر: | Journal of the American Heart Association [J Am Heart Assoc] 2024 Aug 06; Vol. 13 (15), pp. e034026. Date of Electronic Publication: 2024 Aug 05. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Oxford : Wiley-Blackwell |
| مواضيع طبية MeSH: | Disease Models, Animal* , Shock, Septic*/physiopathology , Shock, Septic*/complications , Stroke Volume*, Animals ; Dogs ; Magnetic Resonance Imaging ; Edema, Cardiac/physiopathology ; Edema, Cardiac/pathology ; Edema, Cardiac/diagnostic imaging ; Ventricular Function, Left ; Time Factors ; Humans ; Staphylococcal Infections/complications ; Staphylococcal Infections/physiopathology ; Echocardiography ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Dysfunction, Left/diagnostic imaging ; Ventricular Dysfunction, Left/etiology ; Male |
| مستخلص: | Background: Septic shock is associated with increases in end-diastolic volume (EDV) and decreases in ejection fraction that reverse within 10 days. Nonsurvivors do not develop EDV increases. The mechanism is unknown. Methods and Results: Purpose-bred beagles (n=33) were randomized to receive intrabronchial Staphylococcus aureus or saline. Over 96 hours, cardiac magnetic resonance imaging and echocardiograms were performed. Tissue was obtained at 66 hours. From 0 to 96 hours after bacterial challenge, septic animals versus controls had significantly increased left ventricular wall edema (6%) and wall thinning with loss of mass (15%). On histology, the major finding was nonocclusive microvascular injury with edema in myocytes, the interstitium, and endothelial cells. Edema was associated with significant worsening of biventricular ejection fractions, ventricular-arterial coupling, and circumferential strain. Early during sepsis, (0-24 hours), the EDV decreased; significantly more in nonsurvivors (ie, greater diastolic dysfunction). From 24 to 48 hours, septic animals' biventricular chamber sizes increased; in survivors significantly greater than baseline and nonsurvivors, whose EDVs were not different from baseline. Preload, afterload, or heart rate differences did not explain these differential changes. Conclusions: The cardiac dysfunction of sepsis is associated with wall edema. In nonsurvivors, at 0 to 24 hours, sepsis induces a more severe diastolic dysfunction, further decreasing chamber size. The loss of left ventricular mass with wall thinning in septic survivors may, in part, explain the EDV increases from 24 to 48 hours because of a potentially reparative process removing damaged wall tissue. Septic cardiomyopathy is most consistent with a nonocclusive microvascular injury resulting in edema causing reversible systolic and diastolic dysfunction with more severe diastolic dysfunction being associated with a decreased EDV and death. |
| التعليقات: | Update of: bioRxiv. 2024 Feb 08:2024.02.05.578971. doi: 10.1101/2024.02.05.578971. (PMID: 38903100) |
| فهرسة مساهمة: | Keywords: cardiac dysfunction; edema; sepsis |
| تواريخ الأحداث: | Date Created: 20240805 Date Completed: 20240806 Latest Revision: 20240813 |
| رمز التحديث: | 20240813 |
| DOI: | 10.1161/JAHA.123.034026 |
| PMID: | 39101510 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2047-9980 |
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| DOI: | 10.1161/JAHA.123.034026 |