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Related Experiment Videos

When does the heart fail during shock?

R M Raymond1

  • 1Department of Surgery, Loyola University, Stritch School of Medicine, Maywood, Illinois.

Circulatory Shock
|January 1, 1990
PubMed
Summary
This summary is machine-generated.

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In early shock, the heart

Area of Science:

  • Cardiovascular Physiology
  • Shock Pathophysiology

Background:

  • Early shock research focused on peripheral vascular dysfunction.
  • Recent focus is on the heart as a primary target in shock.
  • Controversy exists regarding early cardiac failure in hypodynamic shock.

Purpose of the Study:

  • To investigate early cardiac contractility changes in experimental shock.
  • To differentiate between myocardial contractility and global myocardial performance.
  • To explore mechanisms of cardiac energy deficit in lethal endotoxin shock.

Main Methods:

  • Utilized the slope of the left ventricular pressure-dimension relationship (Ees) as an index of myocardial contractility.
  • Administered propranolol to assess beta-adrenergic receptor involvement.

Related Experiment Videos

  • Measured myocardial ATP and creatine phosphate levels in endotoxin shock models.

    • Main Results:

    • Myocardial contractility increased early in endotoxin and splanchnic artery occlusion shock.
    • Ees and LV dP/dt do not uniformly reflect contractility changes.
    • Beta-adrenergic stimulation contributed to increased contractility during endotoxin shock.
    • Hearts in fatal endotoxin shock showed progressive energy deficits; survivors maintained high-energy phosphates.

    Conclusions:

    • Cardiac contractility may increase early in certain shock models, contrary to some reports.
    • LV dP/dt reductions primarily reflect altered loading conditions, not solely contractility.
    • Energy deficit is implicated in cardiac failure during lethal endotoxin shock.
    • Mechanisms of late-phase cardiac failure in shock require further elucidation.