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The effect of hyperdynamic sepsis on myocardial performance
Circulatory Shock
|January 1, 1985
Summary
Gram-negative septicemia impairs cardiac function due to intrinsic myocardial dysfunction, not low blood flow. This cardiac dysfunction is evident under stress, even when resting heart function appears normal.
Area of Science:
- Cardiology
- Septicemia Research
- Myocardial Pathophysiology
Background:
- Gram-negative septicemia presents a hyperdynamic circulatory phase.
- Cardiac reserve is crucial for maintaining adequate circulation during stress.
Purpose of the Study:
- To investigate the mechanisms of cardiac dysfunction during the hyperdynamic phase of gram-negative septicemia.
- To determine if myocardial dysfunction is intrinsic or secondary to circulatory changes.
Main Methods:
- Review of studies on cardiac function during septicemia.
- In vitro isolated perfused working heart preparation from septic rats.
- Analysis of myocardial work function curves.
Main Results:
- Intrinsic myocardial dysfunction occurs during the hyperdynamic phase of septicemia.
- Cardiac function is depressed under stress, despite normal resting indices.
- Elevated cytosolic calcium concentration may impair ventricular relaxation.
Conclusions:
- Myocardial dysfunction in septicemia is an intrinsic process.
- Altered myocardial metabolism is unlikely to be the primary cause.
- Early cardiac dysfunction precedes circulatory shock in sepsis.