Myokardiální dysfunkce v sepsi--charakteristika a patogenetické mechanizmy
[Myocardial dysfunction in sepsis--definition and pathogenetic mechanisms]
Jazyk čeština Země Česko Médium print
Typ dokumentu anglický abstrakt, časopisecké články, přehledy
PubMed
20394208
- MeSH
- autonomní nervový systém patofyziologie MeSH
- cytokiny fyziologie MeSH
- endotoxiny fyziologie MeSH
- kardiomyopatie etiologie patofyziologie MeSH
- koronární cirkulace MeSH
- lidé MeSH
- myofibrily fyziologie MeSH
- myokard metabolismus MeSH
- oxid dusnatý fyziologie MeSH
- sepse komplikace MeSH
- srdeční mitochondrie fyziologie MeSH
- TNF-alfa fyziologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- cytokiny MeSH
- endotoxiny MeSH
- oxid dusnatý MeSH
- TNF-alfa MeSH
Sepsis is considered to be the major cause of morbidity and mortality of patients hospitalised in intensive care. It's defined as a systemic inflammatory response of organism to infection. Incidence of myocardial dysfunction in studies with severe sepsis patients is up to two thirds of patients. Cardiac dysfunction shows a continuum from isolated and mild diastolic dysfunction to combined severe diastolic and systolic failure of both ventricles mimicking even cardiogenic shock in some patients. Typical features of septic myocardial dysfunction (SMD) are decrease in ejection fraction (EF) with dilatation ofventricles, e.g. increase in end-diastolic volume (EDV). Reversibility of myocardial dysfunction during a period from 7 to 10 days in survivors is other typical manifestation of SMD. Hence, one can speculate that development of such a type ofSMD as a temporary protective compensatory mechanism could be advantageous for of an individual patient. A large body ofevidence about mechanisms ofSMD was described; endothelial dysfunction with consequent microcirculatory and mitochondrial dysfunction and role of circulating factors are considered to be the most important.