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Development of myocardial dysfunction in endotoxin shock.

J L Parker, H R Adams

    The American Journal of Physiology
    |June 1, 1985
    PubMed
    Summary

    Endotoxin shock causes early and progressive heart muscle dysfunction in guinea pigs. This intrinsic myocardial dysfunction can be studied using isolated heart muscle preparations.

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    Area of Science:

    • Cardiology
    • Pathophysiology
    • Pharmacology

    Background:

    • Endotoxin shock, often caused by Gram-negative bacteria, can lead to multi-organ failure.
    • Myocardial depression is a known complication of sepsis and endotoxin exposure.
    • The precise timing and intrinsic nature of cardiac dysfunction in endotoxin shock require further elucidation.

    Purpose of the Study:

    • To investigate the onset and progression of myocardial inotropic dysfunction during endotoxin shock.
    • To assess the intrinsic contractile function of isolated heart muscle preparations from endotoxin-shocked guinea pigs.
    • To characterize the temporal development of myocardial dysfunction and its altered responsiveness to various stimuli.

    Main Methods:

    • Isolated left atrial muscle preparations were obtained from guinea pigs at various time points after endotoxin administration.
    • Contractile tension (CT) and maximal rate of tension development (+dT/dtmax) were measured.
    • Muscle preparations were also exposed to low calcium, gentamicin, and hypoxia to assess functional responses.

    Main Results:

    • Significant depression of CT and +dT/dtmax was observed as early as 2 hours post-endotoxin.
    • The contractile deficit progressively worsened up to 12 hours and remained depressed at 24 hours.
    • Isolated heart muscle preparations showed altered contractile responsiveness to low calcium, gentamicin, and hypoxia, mirroring basal contractile changes.

    Conclusions:

    • Endotoxin shock induces early and progressive intrinsic myocardial dysfunction in guinea pigs.
    • In vitro studies of isolated heart muscle preparations are valuable for unmasking and characterizing this dysfunction.
    • The findings highlight the direct impact of endotoxin on cardiac contractility during shock.

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